Preamble

The House met at half-past Two o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

PRIVATE BUSINESS

CITY OF LONDON (WARD ELECTIONS) BILL (BY ORDER)

Order for further consideration, as amended, read.

To be further considered on Wednesday 19 July.

Oral Answers to Questions — CABINET OFFICE

The Minister was asked—

Social Exclusion

Mr. Vernon Coaker: What assessment she has made of the impact of the Government's measures to tackle social exclusion. [128644]

The Minister for the Cabinet Office (Marjorie Mowlam): I have held meetings with my ministerial colleagues over the past two months to ensure that the social exclusion unit's past reports are being implemented, and that progress towards the agreed targets is being made. The reports are on truancy and school exclusion, rough sleepers, teenage pregnancy and bridging the gap.

Mr. Coaker: I consider the unit's work phenomenally important. As my right hon. Friend says, the reports are mostly about young people. When considering young people at the bottom end of society who have severe problems, will she ensure that the Government listen to what they themselves have to say about solutions to their problems? Will she also do all that she can to establish bodies such as youth forums, so we can listen to young people, learn from their experience and thereby make better policy?

Marjorie Mowlam: I assure my hon. Friend that we do an awful lot of that already. The social exclusion unit's reports are compiled by a committee consisting not just of civil servants but of representatives of the voluntary sector, business and trade unions. Those people have a wide range of experience. There are also a number of forums enabling us to listen to old as well as young people. When we were compiling the recent report on "Bridging the Gap", one suggestion made by young people was the provision of a mentor with whom they

could work. The report was a direct result of our having listened to young people—but I assure my hon. Friend that we shall continue to do so.

Sir Sydney Chapman: Does the right hon. Lady agree that a significant factor in the tackling of social exclusion must be regeneration of our inner cities? It is more than a year since Lord Rogers's urban taskforce presented its recommendations, and it could reasonably be assumed that the Government would produce a White Paper within a few months of that. As the right hon. Lady is presumably the Minister responsible for joined-up government, can she tell us when the urban White Paper will see the light of day?

Marjorie Mowlam: I am sorry to disappoint the hon. Gentleman. I do not have a date, but I know that the White Paper will be published soon. I expect it to appear within the next couple of months. I am afraid that I cannot be more specific.
The national neighbourhood renewal strategy, however, has now been produced. The strategy, which was created across departments, deals with the regeneration of neighbourhoods—not just in terms of housing, but in terms of employment, health and education. If those factors are not taken into account, neighbourhoods slip again. Ours is an integrated strategy which I am sure will cover some of the aspects of the urban White Paper.

Countryside

Helen Jackson: What progress has been made in developing a cross-departmental policy for the countryside. [128645]

The Minister for the Cabinet Office (Marjorie Mowlam): The Prime Minister set up a new Cabinet Committee in November 1999 to co-ordinate our policies affecting rural areas, and to help to achieve a fully cross-departmental policy for the countryside. The forthcoming rural White Paper will set out how we are developing a more integrated and effective approach to the countryside.

Helen Jackson: For people in the rural areas of my constituency, life under the last Administration was one long battle, whether they were defending small schools, defending post offices or defending the smaller hill farmers. I congratulate my right hon. Friend on the fact that we now have a Government who are providing support for small schools, an answer to the problems of rural post offices, and a proper countryside management structure. [Interruption.] Does my right hon. Friend agree that, whereas the present Government take the countryside seriously, the last Government simply took it for granted? [Interruption.]

Marjorie Mowlam: I thank my hon. Friend. Let me in turn congratulate the teachers, parents and children who are making the school in her constituency such a success.
Conservative Members were barracking while my hon. Friend asked her question. They should not forget that under the last Government 30 rural schools were closed each year. We are doing all we can, with a £40 million package, to keep rural schools open, because they are an


essential part of the community in rural villages. Only one in four parishes had rural transport when the Conservatives were in government. We have turned that around: we have provided 1,800 new routes, and are working hard to provide more.

Mr. Paul Tyler: Having heard all that, I wonder whether the Minister can now explain why there has been such a delay in the publication of the rural White Paper, which we expected to appear this month? Does she recall that, although the last Government produced a large number of warm words and a lot of pretty pictures in their rural White Paper, its publication coincided with a disastrous deterioration in the rural economy and in rural facilities, including the schools to which she has referred? Can she guarantee that her White Paper will not only represent joined-up government, but genuinely face the problems involved in regenerating the rural economy?

Marjorie Mowlam: One of the reasons why the White Paper has taken time is that we have genuinely worked on it across Departments, and I hope that it will result in what the hon. Gentleman and I desire: a real difference in rural communities. We are looking not just at transport, education and health, but at jobs. We want to work with the private sector on regeneration. We have already put a lot of money into that to help it to work. With the European Union, we have put more than £3.5 billion into support for farmers. We put in another 1.6 billion to get rural development plans up and running. The White Paper is delayed not through lack of trying, but because we want to ensure that it has a real impact.

Ms Helen Southworth: Does my right hon. Friend agree that rural post offices are the hub of the local community; and will she ensure that Government Departments work together to support rural post offices, giving them a vibrant economic future?

Marjorie Mowlam: The work that has been done on protecting the future of rural post offices will be seen to do exactly what my hon. Friend wants. The performance and innovation unit report, which we are implementing and which the relevant Minister at the Department of Trade and Industry has agreed to, will make, I hope, a big difference.
Again, let us be clear. We are working to protect and to keep the post offices open. Claimants can continue to receive benefit across the counter. We are working with the Post Office to ensure that post offices are not closed. With the universal banking system, I hope that we will see a real change in the future of post offices. Ours will be a very different record from the Tories' one: when they were in office, 3,000 rural and edge-of-urban-area post offices closed.

Mr. Peter Lilley: Can the Minister confirm that the reason why the post office network is under threat is that the Department of Social Security proposes to remove a third of the income that post offices receive by cancelling the contract with the Post Office? Can she confirm that the Department of Trade and Industry has failed to put forward any measures that will replace those hundreds of millions of pounds; that the Post Office has revealed that the Horizon project

will not produce extra revenues—it has written off the whole cost of that project on the ground that it will not cover even its own costs; and that the so-called universal bank will simply duplicate the Girobank, which already operates in the post offices, and will therefore not produce extra revenues?

Marjorie Mowlam: At least we are not going to privatise the post offices. The benefits are not being taken away completely. Some are being taken away because that will lead to greater efficiency and a more effective service for the people whom we are all here trying to serve, but people who want to continue to collect their benefits from the post office can continue to do so.
It is not true that the DTI has no strategy. It is working with the recommendations arising from work that it has done, and with the performance and innovation unit to get results.

Mr. Bob Blizzard: Does my right hon. Friend agree that, if we want a prosperous countryside, there will need to be more opportunities for people, particularly young people, to work in the countryside, rather than their having to go to the towns? With that in mind, is it not important that we have more small enterprises in the countryside? Does she agree that we need to change some of the planning guidance—I am talking about PPG7 and PPG13—so that those small businesses can grow and hard-pressed farmers can diversify?

Marjorie Mowlam: We are working to help farmers to diversify. Part of the job of the regional development agencies will be to do what they can. Some of the work is already taking place. For example, the £70 million extra that was given to organic farming will make a difference to farmers who want to make the change. PPG7 and PPG13 are being reviewed by another committee, which is looking at planning across the board—not just for people in rural areas, but for small and big businesses. As we try to decrease unnecessary regulation but protect people's health and safety, the aim is to make things simpler.

Drugs Counsellors

Mrs. Ann Winterton: What progress has been made in recruiting counsellors for drug prevention and treatment specifically in rural areas. [128646]

The Minister for the Cabinet Office (Marjorie Mowlam): In order to expand treatment capacity, the Government recently ran a major national advertising campaign to recruit drug workers and counsellors. The response was exceptional, with more than 20,000 expressions of interest received. Drug action teams are now working on matching applications to vacancies. The Government's 10-year strategy to tackle drugs is designed to combat drug misuse in all parts of the United Kingdom.

Mrs. Winterton: Drug dealers are increasingly targeting young people in rural areas. Not only do young people in those areas have less infrastructure to support them but, at the same time, drug action teams and police


have fewer resources available in those same areas. Will the forthcoming rural White Paper contain a specific commitment to support drug action teams in rural areas?

Marjorie Mowlam: I cannot tell the hon. Lady what the rural White Paper will contain, because I do not know. Although I am working on the White Paper, I do not know what it will finally contain. However, I reassure her that Macclesfield, which is the area covering her constituency of Congleton, will have some of the £70 million that we have just provided to central treatment agencies to increase treatment, where necessary, and to achieve even higher goals.
Education and preventing children from getting into drugs initially are crucial. I am pleased to say that 100 per cent. of Congleton primary schools provide such education. I am sure that both the hon. Lady and I welcome that record.

Mrs. Gwyneth Dunwoody: My right hon. Friend will be aware that the pressure on schools is very great. It is clear that smaller children are now being deliberately targeted not only in rural areas, but in rural towns. Will she pay tribute to the work of the voluntary organisations that, in areas such as Cheshire, are doing tremendous work to help educate primary and pre-primary children on the effects of drugs?

Marjorie Mowlam: I am most willing to congratulate the voluntary sector on the work that it does in educating particularly very young people on the dangers of drugs. I hope that we can do further work in partnership with the voluntary sector on what we call positive futures. We are working with the voluntary sector and particularly with various sports groups, whether football clubs or basketball groups. We are trying to get young people, through peer group pressure, to think of things other than drugs as they grow up. That is working in many towns and cities, and I look forward to the development of other projects.

Mr. David Heath: Given the evidence that, in the prevalence of drug taking and the availability of drugs, there is very little difference between rural areas and urban areas, is there anything that the right hon. Lady can do to reduce the disparity in the provision of youth services between rural areas and urban areas? Youth services could provide very useful counselling and advice services on drugs.

Marjorie Mowlam: I cannot give the hon. Gentleman a direct answer now, but if he would like to tell me the specific areas that he is referring to, I shall talk to the Department with responsibility for youth services and see what it can do.

Mr. Lindsay Hoyle: Although rehabilitation units have been established in rural areas, they unfortunately really do lack funding. What help and financial support could be given to the groups that have already been established?

Marjorie Mowlam: That is exactly what we are in the process of doing. We have just advertised for drug counsellors, and we are beginning training, so that staff are available to work in the centres. We are also putting £70 million extra into drug treatment. As we realise that it is no good starting the centres if we do not have the

workers, we are working through the matter logically, ensuring that we have both workers and centres. We hope that we will soon see the results of that work. I accept my hon. Friend's point that there are waiting lists in some areas, but not in others.

Better Regulation Taskforce

Mrs. Jacqui Lait: If she will make a statement on the work of the better regulation taskforce. [128647]

The Parliamentary Secretary, Cabinet Office (Mr. Graham Stringer): The independent better regulation taskforce was established in 1997. Since then, it has reported 18 times. Some of those have been annual reports, and others have been intermediate reports. Later this year, the taskforce plans to report on alternatives to state regulation and on regulation as it affects vulnerable people. The future work programme has yet to be finalised—although, as part of the Government's action plan for farming, which was announced in March, the taskforce has started a review of environmental regulations, with particular reference to farmers.

Mrs. Lait: When I was an active member of the Select Committee on Deregulation, I was very impressed by Lord Haskins's commitment to better regulation. In the light of his taskforce's recent stinging criticism of the increasing regulatory burden imposed by this Government, can the Minister tell us whether he even listened to the poor man—or are the Government all mouth and no delivery?

Mr. Stringer: I agree that Lord Haskins is doing an extremely good job, but otherwise the hon. Lady completely misrepresents the position. If she looks back over reports in which recommendations were made, she will see that the Government have responded to them within the 60 days stated and have agreed to implement the vast majority of those recommendations. If she looks in detail at the report she has cited about the impact of regulation on the hotel and restaurant industry, where one in seven new jobs is created, she will find that Lord Haskins, while recommending changes in some areas of regulation, says that that sector experiences no competitive disadvantages compared with other countries. That contradicts the previous research done by McKinsey.

Tony Wright: Does my hon. Friend accept that although we have a system to assess the effect of regulation and compliance costs on the private sector, we have no equivalent system for the public sector? However, much of what we do bears heavily on the public sector and carries substantial compliance costs. Could we have a system equivalent to that for the private sector which will assess the compliance costs for the public sector of legislation that we introduce?

Mr. Stringer: My hon. Friend makes a good point, as ever, and he is 95 per cent. right. The 5 per cent., on which there has been some progress, is within the regulatory impact unit. A public sector team has been set up to consider the impact of regulations on the delivery of public services. Its first report was published in March and it concentrated on the bureaucracy and red tape


surrounding the police. Its recommendations led to a reduction of 1.2 million in the number of police forms used across the United Kingdom.

Mr. Andrew Lansley: It is good to see the Minister for the Cabinet Office in her place. We missed her during the debate last week. Does the Parliamentary Secretary recognise that the better regulation taskforce said in April that policy makers are ignoring the needs of small businesses when drafting regulations? Does he understand that it is not only the character of regulation but also the quantity that matters to small businesses?
Let us look at the substance, not the spin. In the three months after the right hon. Lady took office as Minister, how much legislation was introduced that required a regulatory impact assessment and how many deregulation orders were published?

Mr. Stringer: There is no doubt that regulation impacts disproportionately on small businesses. That has been recognised by the Government and by Lord Haskins in his report, and the Government are considering his recommendations. Over the past three months, no deregulation orders have been passed and that is one of the reasons why we are considering a regulatory reform Bill. I remind the hon. Gentleman that when Neil Hamilton and the right hon. Member for Henley (Mr. Heseltine) were considering regulation, they promised to burn piles of red tape, but in the three years after the passing of the Deregulation and Contracting Out Act 1994 they passed only 30-odd deregulation orders. That implies that the process dealt with some regulations that could be improved, but not with the vast majority, which is why we need a regulatory reform Bill.

Mr. Lansley: We got half an answer—that there were no deregulation orders in the three months in question—but we did not get the other half, which is that there were 59 items of legislation introducing additional costs on business—or one per working day—in that period. Does the Minister understand that 3,000 additional regulations under this Government, costing business £10 billion, are an enormous quantity? The better regulation taskforce has said that it is the "cumulative effect" of all regulations that should be the subject of Government strategy. There is no such strategy, so will the Minister endorse our proposal to cut the burden of regulations as a whole?

Mr. Stringer: If the hon. Gentleman were to examine the previous Government's record, he would find that, year by year, the previous Government passed 3,000 statutory instruments, which is almost exactly the same number as the present Government have passed. In fact, it is almost invariant. The Government will not apologise for introducing the minimum wage and protection for workers and others who need environmental protection. We need to achieve a balance between the cost of regulations and protecting people.

Life Education Centres

Mr. David Taylor: What assessment she has made of the work of life education centres in relation to the drug prevention

programmes in primary schools; what funding proposals she has in relation to expanding their work; and if she will make a statement. [128649]

The Parliamentary Secretary, Cabinet Office (Mr. Graham Stringer): My right hon. Friend the Secretary of State for Education and Employment is very familiar with the work of life education centres, and officials in his Department remain in close contact with the organisation. The approach to drug education that life education centres offer is one of a number that schools may choose to adopt, but the decision must be made at a local level, in order to address the specific needs and circumstances of the pupils.
In support of the Government's 10-year anti-drug strategy, the Department for Education and Employment has, through the standards fund, made some £7.5 million available to local education authorities to support drug education in schools. Local education authorities may choose to use some of that money to provide life education centres in mobile classrooms.

Mr. Taylor: In underfunded education authorities such as Leicestershire, much drug prevention work in the primary sector depends on generous contributions from Rotary clubs and from parents and schools. Is my hon. Friend convinced that £7.5 million for 7.5 million children of school age is adequate support for this crucial work and for organisations such as life education centres? Will he ask my right hon. Friend the Chancellor of the Exchequer to boost the core funding of this work so that we can ensure that children make healthy choices and continue to wage an unremitting war against drugs in our country?

Mr. Stringer: I agree with my hon. Friend's sentiments. That is why, at the last comprehensive spending review, the Government put more than £200 million extra into the fight against drugs. I am sure that my right hon. Friend the Chancellor of the Exchequer has listened to my hon. Friend's case, and my hon. Friend should listen to what my right hon. Friend has to say next week in his spending review statement.

Mr. Nigel Evans: Seven and a half million pounds is chicken feed compared with the £2 billion a year that the Government are spending on more government. In Lancashire we do rather well for life education centres, but they are supported by groups such as Rotary. I fear that other local authority areas may have no cover from organisations such as life education centres. What encouragement can the Minister give to other charitable groups to buy in life education centres for their areas, or to businesses to sponsor life education centres for primary schools?

Mr. Stringer: Some areas are not covered by life education centres because it is a matter for the school and the local education authority. Quite simply, the £7.5 million that is going into educating children and getting them to make the critical decision not to accept drugs is £7.5 million more than the previous Government were willing to give.

Mr. Hilton Dawson: Will my hon. Friend visit some of the life education centres and


see their work? Had he been with me at Bowerham county primary school in Lancaster, he would have witnessed an excellent programme which fully involves very young children and complements the work of that first-class school.

Mr. Stringer: My right hon. Friend the Minister for the Cabinet Office has already visited a number of the centres. I am sure that she and my right hon. Friend the Minister of State will be delighted to visit a number of others to further the fight against drugs.

Oral Answers to Questions — PRIME MINISTER

The Prime Minister was asked—

Engagements

Mr. Ben Bradshaw: If he will list his official engagements for Wednesday 12 July.

The Prime Minister (Mr. Tony Blair): This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I shall be having further meetings later today.
The House will no doubt be aware of the sad news of the death of the former Archbishop of Canterbury, Lord Runcie. Lord Runcie was a man of great faith and moral courage, who carried the Church of England united through momentous and historic times. He was also a spiritual man of humility and modesty, who will be missed by millions of ordinary people who saw him as their friend, both inside and outside the Anglican Church.

Mr. Bradshaw: Does my right hon. Friend agree that voters at the next election will make a judgment based on facts in the real world, rather than on the froth that sometimes swirls around this place? In Exeter, those facts include record employment, more doctors and nurses, a refurbished accident and emergency department, a new renal unit, two new health walk-in centres, more teachers and classroom assistants, more school buildings, more bus services, and much more. How much of that will Exeter lose under £16 billion of Conservative spending cuts?

The Prime Minister: That is right, of course, because a very significant thing happened yesterday. Nine months ago, the Conservatives said:
Our guarantee on tax is clear. For the very first time, there will be no escape clauses, no fudging. No hiding behind the fine print.
They also said that they were
prepared to stake our fate on meeting
the guarantee.
The stake was driven through the policy yesterday. Not only did the shadow Chancellor disintegrate the credibility of the right hon. Member for Richmond, Yorks (Mr. Hague) on tax, he impaled him—as my hon. Friend said—on a £17 billion cuts guarantee. That is the new guarantee. Every Conservative Member had better realise

that it adds up to £24 million of cuts—in schools, hospitals, transport and police—in every constituency on the country. Yes, there is a dividing line now.

Mr. William Hague: May I begin by associating the Opposition with the Prime Minister's remarks about Archbishop Runcie? We will remember him for his integrity and moral leadership, and we entirely join in the Prime Minister's tribute to him.
On domestic political matters, does the Prime Minister agree with everything that the Foreign Secretary has said about the euro over the past week?

The Prime Minister: Given the publication of the Conservative party's tax and spending policy, I thought that I might have been asked about that.
I entirely agree. In principle, we are in favour of membership of the single currency; in practice, the economic tests must be met.

Mr. Hague: Do we not have an extraordinary situation in a Cabinet, where the Prime Minister cannot give a straight yes as to whether he agrees with his own Foreign Secretary? Are not the Government utterly divided and shambolic? The Prime Minister cannot agree with the Foreign Secretary on a central issue of policy. He wants the right hon. Member for Livingston (Mr. Cook) to be Foreign Secretary—no one else does.
The Foreign Secretary said on Thursday that it was "inevitable" that Britain would join the euro. Does the Prime Minister agree with that statement, yes or no?

The Prime Minister: We have made it absolutely clear that, in principle, we are in favour of joining the euro and that, in practice, the economic tests have got to be met. The difference between the Labour party and the Conservative party is clear. The right hon. Gentleman has another guarantee—his sterling guarantee that he is going to keep the pound. Will he keep the pound for just one Parliament, or more?

Mr. Hague: The Foreign Secretary is now pursuing his own private policy on the euro—[Interruption.]

Madam Speaker: Order. The House must come to order—I cannot hear.

Mr. Hague: The Foreign Secretary, who has mysteriously disappeared this afternoon, is pursuing his own private policy on the euro. The Prime Minister is too weak to get a grip on the Cabinet. He said last week—[Interruption.] I know that Labour Members do not like to hear the truth about the Government. He said last week that he would sack anyone briefing against Ministers, since when a friend of the Chancellor—that narrows down the lists of suspects dramatically—has said, "Tony and Gordon have both agreed to rubbish Cook."
The Prime Minister goes on about his five economic tests on the euro, but the test that really matters is of leadership on the euro, and he has failed it. Is it not time


that he changed the policy or changed the Foreign Secretary, or that we change to a Prime Minister who will keep the pound?

The Prime Minister: Oh, so the right hon. Gentleman is going to keep the pound now. Tell me—is that a guarantee or just something that he intends doing? Have we got another guarantee there?
I think that it is the right hon. Gentleman who wishes that he had disappeared this afternoon. The fact is that we have the right policy—in principle in favour and in practice the economic tests must be met. At the next election, on many other areas of policy as well as the euro, there are clear dividing lines. We do not rule it out—we will give the people a choice in a referendum. On public spending, we want to invest in the country's future, and on the national health service, we want to rebuild it, not privatise it. That is the real test—the policies for the future of this country, or a Leader of the Opposition who jumps up at one party conference and says that he has five guarantees, and nine months later not a single one of them stands.

Mr. Hague: Today the Prime Minister has attempted the third relaunch of his Government in a single month under the inspiring slogan of "We're getting there"—a slogan last used by British Rail when it was not getting anywhere. Is not what is really behind that the desperation of Ministers to conceal next week's crime figures and their utter failure on crime? The Government obviously have the figures, so will the Prime Minister now come clean and tell the House the figures for the rise in crime?

The Prime Minister: I think that the right hon. Gentleman is the one in need of a relaunch. Let me just tell him about the policy. What is important with rising crime is that we are now able to make the investment in extra numbers of police officers. Let us have a little discussion about this. It is correct that for the past six years—three years under the previous Government, three years under ours—police numbers have fallen. Now, as a result of the additional money, they will rise. We know, however, from the spending policy adopted yesterday, that the right hon. Gentleman is due to cut the numbers. Every person concerned about crime and every police officer in the country knows that if the right hon. Gentleman comes to power, he will cut police numbers further.

Mr. Hague: So the relaunch did not extend to giving a straight answer to a question. If the right hon. Gentleman will not tell the House the figures, I will, because although the Prime Minister will not give a straight answer, the police force does. Taking 33 out of 43 police forces, there were 183,000 more crimes committed in the past year than in the year before. Under this Government, is it not the burglars who have had a relaunch, the muggers who are fighting back, and the violent criminals who have a new deal? Will the right hon. Gentleman now confirm the figures of the police that show that at least 183,000 more crimes were committed in the past year?

The Prime Minister: Of course it is true that in the past year there has been a 3 to 4 per cent. rise in crime, as we know. Over the period of this Government, there has been a fall in crime. What we also remember, however, is that when the right hon. Gentleman was in

office crime doubled. The question is: what do we do? We now have proposals on youth justice; with three strikes and you are out for burglary—that is why burglary figures are falling; on drugs and crime through the new criminal justice measures; and there is investment in the police and in their equipment.
Let us get to the difference between the two of us. I believe that the priority is to make that investment in schools, hospitals, transport and the police. Does the right hon. Gentleman stand by the cuts guarantee on spending made yesterday by himself and the shadow Chancellor, or does he not? If he does, anything he says on police numbers has no credibility whatever.

Mr. Hague: This morning, the right hon. Gentleman stood up in Downing street and said "We're getting there"; but millions of people throughout Britain know that this Government are getting nowhere. What does it say to people who are more likely to be victims of violent crime when the Prime Minister says "We're getting there."? What does it say to people waiting longer to see a hospital consultant when he says, "We're getting there."? What does it say to people whose teenage children are in larger classes? What does it say to people persecuted by the Chancellor every time they drive their car when he says, "We're getting there."? It says to those people that this Government are complacent and incompetent and that they have lost touch with the people they were elected to serve.

The Prime Minister: On the subject of incompetence, let us look at the right hon. Gentleman's national health service guarantee. Nine months ago, he said that every patient would have a guaranteed waiting time in the NHS under the Conservatives. It took two questions on BBC's "Question Time" for him to say, "Of course, we couldn't say that everyone was going to get a guaranteed waiting time." That is my definition of incompetence.
It is true that we have raised public spending; it is correct that class sizes are down for five, six and seven-year-olds; and there is extra money for school buildings, but it is true that we still have a long way to go on schools. Yes, the in-patient lists are coming down, but we still have far more to do in the health service. It is also true that we need to make additional investments in our police and transport. However, we now know that all those investments would be cut by the right hon. Gentleman. Whatever he says about public services, the one thing that everyone in the country now knows is that if they vote Tory at the next election, there will be fewer nurses, fewer teachers, fewer police officers and fewer hospitals.

Mr. Paul Truswell: Is my right hon. Friend aware of the growing concern of the people of Yorkshire at the plans of Kelda plc to offload Yorkshire Water on to its customers now that it has exploited the easy pickings of water privatisation? Does he agree that that cannot be allowed to proceed without fuller and further consultation with Yorkshire people, including a ballot of every Yorkshire Water customer?

The Prime Minister: I agree with my hon. Friend that the proposals raise important issues. I understand that my right hon. Friend the Minister for the Environment is meeting the regulator today to discuss those issues.


The Government want to ensure that any reorganisation will direct long and lasting benefits to customers, and that companies comply with their public health and environmental obligations. I am aware of my hon. Friend's concerns; a meeting with the regulator is taking place; and I hope that the matter can be resolved satisfactorily.

Mr. Charles Kennedy: I entirely associate my right hon. and hon. Friends with the tribute that the Prime Minister so properly paid to the late Lord Runcie, the former Archbishop of Canterbury.
Whatever view the Conservatives may express on the euro, the Liberal Democrats, in acknowledging that it is both inevitable and desirable, certainly agree with the Foreign Secretary—very happily so.
On the other issue raised by the Leader of the Conservative party, if, next week, the Home Office figures show that violent crime has gone up yet again—as widely anticipated—whom will the Prime Minister blame for that?

The Prime Minister: I entirely accept our responsibility to do the very best we can to change that situation. What is happening is that crime is not rising in every police area; in many it is still falling. It is correct that the number of burglary and car crimes are falling; the rise is in violent crime. We need to tackle that—both by extra investment, as I have already indicated, and by measures in the criminal justice system. I hope very much that the right hon. Gentleman will support the measures such as those to ensure that, before those who are tested positive for drugs are given bail, they agree to take treatment for their drug condition. I think that such measures in the criminal justice system are an important part of turning the tide back.

Mr. Kennedy: Is it not the case that, rather than appointing a part-time Lord Birt to look at the issue, the public want more full-time police on the streets and in the community? Is not the sad fact of the matter that, having spent years in opposition quite rightly criticising the Tories for their lamentable record and for the decline in police numbers, the Government in office have presided over exactly the same story?

The Prime Minister: I have been open about the first three years of the Government and the position on police numbers, but I have also said that we now have the ability to make the investment. As a result of the measures that we have taken with more people in work, welfare bills falling and interest payments on the debt falling, we are able to get more investment into the police. What we have said all the way through—I say it again today—is that by the end of the year police numbers again should be rising. I agree with the right hon. Gentleman that is one part of what we have to do, but we can do it only if we are prepared to make the commitment to invest.

Mrs. Claire Curtis-Thomas: Three years ago, the Government announced a £1.4 billion injection into the science budget and last week we heard that an additional £1 billion would go into that budget. That money is desperately needed and is welcomed by the vast majority of scientists and engineers working in this country. Under the previous Administration, that potential

was ignored. [Interruption.] Does my right hon. Friend agree that that funding will be put to good use and that it will enable us to realise our potential? Will he also take the time to reassure me that he will look with special interest on the north-west, because I remain deeply concerned that we need to realise our potential there? I hope that this funding will enable us to do so.

The Prime Minister: Yes. My hon. Friend should know that the Conservatives are shouting at her because they do not want to hear the facts about what they intend to do to the science and education budgets. I am afraid that the science and education budgets would also be cut under the Conservative party were it to come back to power. The £1 billion announcement on science is very important and the reason for the investment is that stability in the economy is important. More jobs are obviously important, but we also have to make that critical investment in the nation's prosperity. Unless we also make the investment in education, skills, technology, science and the transport infrastructure, we will not be able to guarantee—if I can use that word—prosperity and opportunity for people in the future.

Mr. James Gray: Will the Prime Minister give careful consideration to the recommendation by Lord Norton that Prime Minister's Question Time should return to twice a week? Does the Prime Minister agree that, if that were to happen, it would provide greater accountability from him to this place and might give him the opportunity to reduce the spin, the rhetoric, the waffle and the general rambling that has characterised his performance to date?

The Prime Minister: I think that we heard rather more waffle today from the Leader of the Opposition than from me I do not agree with the hon. Gentleman about Prime Minister's questions. In fact, if I can give him the figures, compared to the previous Prime Minister, I have spent more time answering questions in the House and more time giving statements.
I am glad that the hon. Gentleman has asked me a question, because he was the person who famously said after the election that employers would
lay off workers the morning after he—
me, that is—
brings in the minimum wage.—[Official Report, 21 May 1997; Vol. 294, c. 710.]
I am delighted to tell him that the fall in youth unemployment in his constituency since the general election is 79 per cent. There is some substance for him.

Mr. Neil Gerrard: My right hon. Friend the Prime Minister will have seen the reports on the international AIDS conference in Durban this week. Although he might share my disquiet that President Mbeki appears to have given some support to people who would deny the scientific evidence on the links between HIV and AIDS, does my right hon. Friend agree that President Mbeki was absolutely right to point to the problems of drug pricing, poverty and the lack of access to basic education and health? Will my right hon. Friend use the next opportunities that he has, through the G7 or the European Union, to press for a substantial increase in support to the countries that are suffering the worst from


this epidemic, so that the rich countries of the world start to make a contribution that begins to match up at last to the size of the problem?

The Prime Minister: I agree strongly with my hon. Friend. Of course we shall raise the issue of AIDS in the developing world and the problem of debt at the summit in Japan in the next couple of weeks. I entirely agree with my hon. Friend that it is important to link in action on poverty in the developing world. In addition, we have put special investment into South Africa to tackle the serious HIV-AIDS problem, which is significantly reducing life expectancy in many countries in Africa when, throughout the rest of the world, people are looking forward to increased longevity. That is an important part of the strategy of the Department for International Development.

Mr. Tom Brake: Since the election, the number of police officers in London has fallen by 800, and the number of officers in Sutton has fallen by 21 in the past couple of months. Retention is still a problem in the service, which is the view that Sir John Stevens expressed a couple of days ago, after the Home Secretary's welcome announcement on pay for the Metropolitan police. Can the Prime Minister give my constituents a guarantee that Sutton police will have the resources that they need to make Sutton not the second safest borough in London, but the safest? Can he guarantee my constituents that the number of police officers will not fall below the 25,600 which Sir John Stevens believes is necessary?

The Prime Minister: First, the hon. Gentleman is right to draw attention to the fact that, as a result of housing costs and other issues that we are trying to address, there are particular problems in London with retention and recruitment. However, it is important that we start to bring in investment, which can help to increase police numbers. That should be happening in the Metropolitan police area and elsewhere by the end of the year.
I accept the points raised by the hon. Gentleman. When we first came to office, we had to make difficult decisions on public spending and I very much hope that, when the comprehensive spending review is published next week, the hon. Gentleman's party will join ours in saying that the country really needs those investments to secure its future.

Liz Blackman: John Reddington, a former child migrant, will shortly return to my constituency from Australia, not having seen his home for 50 years. That was a shameful policy practised by both countries in the post-war years. Will my right hon. Friend press the Federal Australian Government to make funding available, as this Government have, to ensure that more migrants can be reunited with their families? Does he agree that some kind of joint responsibility for that atrocity is essential?

The Prime Minister: I discussed that matter with the Australian Prime Minister when he was here. I agree entirely with my hon. Friend that is important that we make sure that we try to at least alleviate the pain so far as we can for people who had an immensely traumatic experience when young.
If my hon. Friend will allow me, I will write to her on the issue of funding. I do not know the up-to-date position vis-a-vis the Australian Government. From our point of view, we have made some funding available, and I hope that we can do more.

Prime Ministerial Visits

Mr. Martin Bell: What plans he has to visit the Tatton constituency.

The Prime Minister: I have no immediate plans to do so.

Mr. Bell: My constituents will be deeply disappointed that the Prime Minister is unable to experience the spirit of Tatton for himself. I know that they would be interested in his answer to a question that I know concerns them, having recently had an Adjournment debate on the issue, namely the verdict of gross negligence on the two pilots of the RAF Chinook that crashed in the Mull of Kintyre six years ago. Will the Prime Minister give that personal attention as a question of natural justice?

The Prime Minister: I am happy to give the issue my personal attention. I know that, with other hon. Members, the hon. Gentleman has run a significant campaign for some time on this tragic incident and that he secured an Adjournment debate on it. The RAF investigation into the crash was painstaking and exhaustive. All possible causes were examined, but no evidence of technical malfunctioning was found. The RAF board of inquiry established that the Chinook was flying too fast and too low in bad weather.
We have consistently said that we are ready to consider new evidence, but without new evidence it is difficult for us to justify reopening the inquiry. However, I will of course look into the matter personally as a result of the hon. Gentleman's question, and I will be in touch with him about it.

Engagements

Mr. Steve Webb: Does the Prime Minister now regret putting just 75p on the pension this April.

The Prime Minister: As the hon. Gentleman knows, 75p is not all the money that has gone to pensioners. We had to decide whether to put everything on to the basic state pension, and we believed that it was better to give specific sums, such as the £150 winter allowance, the free television licences for the over-75s and free eye tests, which are very important; more and more pensioners are taking them up.
The other choice that we had to make was which pensioners to help first. Many people do not understand that there are 500,000 pensioners in this country who do not even receive the basic state pension because their contributions and those of their husbands were not enough. Those people have existed solely on income support. Through the minimum income guarantee we have boosted their income very substantially indeed—sometimes by between £15 and £20 a week. Of course,


we now want to do more for other groups of pensioners, but overall in this Parliament we will have given an extra £6.5 billion to pensioners.
I remind the hon. Gentleman, whom I know had something to do with this policy before the last election, that the Liberal Democrat policy was, in effect, the minimum income guarantee. His party did not pledge to restore the link with earnings, but said rather that it would keep the link with prices. On both policy areas, we have done exactly what the Liberal Democrats wanted. The fact that they have now changed their minds does not surprise me.

Mr. Chris Pond: Will the Prime Minister join me in congratulating Mr. Eric Gates, the head teacher of Chantry school in Gravesend, who recently received a south-east teaching award for his work with parents and the local community? Is my right hon. Friend aware that when Mr. Gates took over the school three years ago, it was in special measures, the roof and the windows were leaking and the school could boast only 40 books in total?
Has my right hon. Friend considered abandoning the education policies that have helped excellent teachers such as Mr. Gates create excellent schools such as Chantry and adopting instead a policy of severe cuts in education spending and the abolition of the effect of local education authorities? If he did so, how long does he think it would be before we returned to falling school standards, leaking roofs and 40 books for each primary school? [Interruption.]

The Prime Minister: Conservative Members definitely do not like it at all. I am afraid that a £17 billion spending cut has to be paid for, and if the Tories are re-elected it will be paid for by cuts in the schools budget. However, it is worse than that because the Conservatives' education policy also means taking £1 billion out of special educational needs. Not only do I think that that policy would be chaotic and wrong; I think that it is cruel, and no political party should have such a policy.

Mr. Robert Walter: The post office at Winterbourne Stickland in my constituency

has been in the same family since 1877. When I visited the post office last week and met four generations of the Sprackling family and about 60 villagers, they were still unconvinced that the Government's proposals on village post offices will see their post office survive 2003. They asked me what will happen to those who, for reasons of poor credit or bankruptcy, are unable to get bank accounts, and which bank will give them an account. Can the Prime Minister guarantee that Winterbourne Stickland will have a post office in 2003?

The Prime Minister: The hon. Gentleman is asking me for guarantees. This lot have guarantees on the brain. We have set out our proposals on the post offices and measures such as the universal bank, and we are working closely with rural and other sub-postmasters and mistresses to try to make them work. In addition, we have been prepared to commit a sum for investment in post offices. I hope that the hon. Gentleman said to the family that he met yesterday, "Well, of course, if we Conservatives comes back to power, we will cut spending." That would have been an honest thing to say, but I suspect that the hon. Gentleman did not say that. I am afraid that it is only just dawning on Conservative Members that they are going to have a lot of explaining to do between now and election day.

Mr. Harry Barnes: Somebody is confused and it is not me. To clear up the confusion, will the Government revisit mineral planning guidance note 3, in respect of opencast mining, to make it clear beyond any doubt that there will be no acceptance of applications when they are opposed on environmental grounds, community grounds and by the community itself? Unfortunately, that matter needs to be cleared up for Derbyshire county council, which has just decided to accept RJB Mining's planning application in my constituency. Obviously, action must be taken to ensure that the council knows exactly where it is supposed to stand.

The Prime Minister: Unfortunately, planning guidance note 3 was, by some extraordinary event, omitted from my box last night, but I shall ensure that that is remedied tonight and write to my hon. Friend.

Speaker's Statement

Madam Speaker: It has been a great honour to serve the House as its Speaker for more than eight years. As hon. Members will recall, I have undertaken on several occasions that the House would be the first to know when I decided to retire. I now wish to inform the House of my intention to relinquish the office of Speaker immediately before the House returns from the summer recess.
As recommended by the Procedure Committee in 1972, I believe that there is clear advantage in a new Speaker being elected during the course of a Parliament. In particular, it ensures that all Members are familiar with the qualities of potential successors. My decision will give my successor a run-in before the general election.
My statement today also gives notice to my constituents in West Bromwich, West that, at the same time as relinquishing the office of Speaker, it is my intention to retire as their Member of Parliament—[HON. MEMBERS: "Oh."] Be happy for me! [Applause.]
I have one more thing to say. The summer recess will allow me to carry out official duties to which I am already heavily committed, and it will give me an opportunity to see my many friends in the black country who have given me loyal support for 27 years and sustained me through the ups and downs of parliamentary life.

The President of the Council and Leader of the House of Commons (Mrs. Margaret Beckett): Madam Speaker, the House has already made it plain that it has heard your statement with deep regret. As a House, we have taken pride and pleasure in your speakership. The whole House will wish to pay tribute to you for the services that you have rendered the House and the nation, but today is not the occasion for that. It might assist the House if I indicate the sequence of events that will now be set in train.
I understand that, following precedent, you wish to make a substantive valedictory statement to the House a few days before we rise for the summer recess, on Wednesday 26 July. On that day, immediately after your statement, the House will pay its tribute to you, on the basis of a motion that the Government will table. You will remain in office throughout the recess, representing the House at international conferences in New York, presiding over the Commonwealth Parliamentary Association annual conference in London and Edinburgh, and making official visits to the Ukraine and the Baltic states. Your retirement will come into effect immediately before the House returns from the recess.
On the first day back after the recess, 23 October, there will be no Question Time and the only business before the House will be the election of your successor. That will take place under the chairmanship of the Father of the House, as provided in Standing Order No. 1.

Madam Speaker: Thank you, Mrs. Beckett. We now proceed to our normal business.

Business of the House

The President of the Council and Leader of the House of Commons (Mrs. Margaret Beckett): With permission, I would like to make a short business statement.
The House will recall that I made it plain on Thursday last that, dependent on discussions through the usual channels, the House might be asked to sit on Friday this week. I can now tell the House that it is proposed that the business for Thursday 13 July will now be an Opposition day, the 17th allotted day, followed by the Second Reading of the Football (Disorder) Bill, and that the House will not be sitting on Friday 14 July.
The House may also like to know that a further text of the Bill, as revised, following the recent discussions of my right hon. Friend the Secretary of State for the Home Department, will be made available from the Vote Office later today.

Sir George Young: I am grateful to the Leader of the House for her statement. We have no objection to sitting after normal hours to deal with important business such as the Football (Disorder) Bill. Can the right hon. Lady confirm that the Government will not be tabling a guillotine motion to cover tomorrow's proceedings? Will she tell the House when we shall be taking the remaining stages of this important piece of legislation? Finally, as the House will now be dealing with additional business, does she plan to postpone the date of the recess or abandon some Government business to make up for the extra business?

Mrs. Beckett: It is not intended to do anything tomorrow other than take the business that I have described. I will be making the ordinary business statement tomorrow, and that will lay plain the course of further discussions. As for the notion that we should change the dates of the recess or abandon some Government business, I was under the impression that I heard co-operation being offered from the Opposition Benches. It does not sound much like it to me.

Mr. Andrew Stunell: I must say, Madam Speaker, that you have taken our breath away.
We, too, are willing to co-operate with the legislation that is coming forward. However, will the Leader of the House assure us that everything will be done to avoid the mistakes of previous legislation that was brought forward at short notice and with limited time to discuss it? Whether it is guns, dogs or yobs, we quite often make a mess of it.
Will the right hon. Lady confirm that tomorrow's debate will be without limit and will allow proper time for discussion? Will she undertake that any further programming of the Bill will be on the basis of co-operation across the Floor of the House?

Mrs. Beckett: The hon. Gentleman knows that we always seek co-operation on these matters. Although the proposed legislation is new, he will know also that many of the proposals within it have been discussed extensively over a substantial period. There have been considerable discussions already and some changes proposed as a result


of them over recent days. The Government are doing their best in somewhat unusual circumstances to meet all the concerns that might be raised.

Mr. Douglas Hogg: Does the Leader of the House understand that there is considerable concern that we do not know when the Bill will be considered in Committee? Will the right hon. Lady please tell us whether consideration in Committee will take place on the Floor of the House or along the Committee Corridor, and when we will learn of the date? Does she understand that many hon. Members would bitterly resent a guillotine motion?

Mrs. Beckett: I remind the right hon. and learned Gentleman that when we last discussed this matter, he pressed me not to take all stages of the Bill's consideration in one day. Of course, the Government will not be doing so. I anticipate being able to give a little more news when Members have had an opportunity to read the further proposals later today. I hope to be able to say something during the ordinary business statement tomorrow.

Mr. John Redwood: As the Leader of the House is re-examining business for the next few days, will she make sure that there is time and opportunity available to cross-examine the relevant Minister on the fly-on-the-wall documentary about to be shown on Mr. Alastair Campbell, and how—

Madam Speaker: Order. This is a limited business statement. I have the statement in front of me, and it is extremely narrow. It concerns only the business for Thursday 13 July. If the right hon. Gentleman can put his question within the terms of the statement, I will take it. It cannot go wider than the business statement.

Mr. Redwood: I quite understand. The important point is that this event will take place on 13 July, and many people outside the House will want to be reassured that, within the crammed day that the Leader of the House is now suggesting, there will be an opportunity to raise the issue of how a man can be both politically committed and a career civil servant, which is a matter of great interest to the press and the wider audience—

Madam Speaker: Order. I do not require the Leader of the House to respond to an unrelated question.

Mr. Eric Forth: As the Bill, certainly in its present draft form, and presumably even in the form that we hope to see later today, may well, and almost certainly will, involve a possible encroachment on traditional civil liberties and a significant increase in police powers, will the Leader of the House give an undertaking that there will be a proper interval between Second Reading and Committee, and between Committee and Report, not only to allow hon. Members time to consider their approach to the Bill, but, as importantly, for hon. Members to listen to what people outside the House have to say about the Bill as it may change between Second Reading, Committee and Report? The Leader of the House, respecting, as I know she does, the proceedings of the House, surely does not assume that the

Bill will somehow sail through in its original form without necessarily being changed between Second Reading, Committee and Report.

Mrs. Beckett: As I am sure the right hon. Gentleman is aware, my right hon. Friend the Home Secretary has held a number of open meetings and remains available to discuss the Bill with hon. Members. The right hon. Gentleman shakes his head, but I remind him, and all those on the Opposition Benches, that the Opposition called for such a measure and undertook to co-operate with it. Of course the Government are doing their utmost within the time constraints to provide as much time and as measured an examination as is possible. Either the Opposition wish to see such legislation facilitated, or they do not. The right hon. Gentleman shakes his head, but those on the Opposition Front Bench say something different.

Mr. Tony Baldry: Will the Leader of the House confirm that there will be more than three hours' debate on the Bill tomorrow, which will mean that it will go beyond 10 o'clock? Will she also confirm that, had the Bill been taken under the proposals put forward by the Modernisation Committee, there would not be a vote tomorrow at midnight, as I suspect will happen, but a vote next Wednesday, when we would simply have to sign our book in one of the Division Lobbies? The Leader of the House smiles, but I suspect that she does so because the Bill effectively demonstrates the nonsense of the Modernisation Committee's proposals.

Mrs. Beckett: No, I fear that it demonstrates the hon. Gentleman's ignorance of them. No change is proposed in the handling of Second Reading.

Mr. Peter L. Pike: Will my right hon. Friend confirm, that, when the previous Government were in office, there were occasions when we had more accelerated business than we will have under the timetable that she has announced for tomorrow?

Mrs. Beckett: I can certainly confirm that. There were many precedents under the previous Government, hut, as we have noticed, it is a matter not of do as we did, but do as we now say.

Mr. John Bercow: Despite the right hon. Lady's desire to expedite the Bill's passage, will she confirm that the Government Whips will not be encouraged to hand-pick Government Back Benchers to sit on the Standing Committee, and that there is a remote prospect that the Government will show some glasnost on the matter?

Mrs. Beckett: My right hon. Friend the Home Secretary has always made it plain that he strongly believes in glasnost.

Mr. Michael Fabricant: Will the Leader of the House clarify from what date we shall be able to table amendments?

Mrs. Beckett: From tomorrow.

Age Equality Commission

Mr. Lawrie Quinn: I beg to move,
That leave be given to bring in a Bill to make provision for the establishment of an Age Equality Commission to advise the Government on discrimination issues in relation to older people.
In moving this ten-minute Bill on such an historic day as today, Madam Speaker, it would be remiss of me not to say that I hope that the age discrimination faced by many in Britain today will not affect you in your long and happy retirement.
Since arriving in the House in May 1997, my weekly constituency surgeries have introduced me to the experiences of hundreds of constituents who feel that they have met the barriers of age in their daily lives. It is my judgment from those interviews that age discrimination is a persistent and disturbing problem which faces far too many in our community.
Like many of our finest seaside communities, my constituency has a higher than average proportion of older citizens. I am grateful for recent research undertaken at the university of Sheffield by Professor Paul Whiteley, who ranked Scarborough and Whitby 37th out of all English and Welsh constituencies in terms of population over the age of 40.
With one in four of my local community of formal pensionable age, compared to a national average of around two out of 11, and seven out of 10 adults in Scarborough and Whitby aged over 40, it is perhaps not surprising that many of my constituents bring their concerns about ageism to my offices in Whitby and Scarborough.
The important work undertaken by Professor Whiteley was commissioned by Age Concern England and published on 4 July this year. It amplifies the demographic patterns that will frame policy-making decisions in the House, and serves as a useful statistical benchmark for the anecdotal evidence presented to many right hon. and hon. Members, including myself, by thousands of ordinary British people who imagined that they had every right to expect a fair deal as they got older. I also commend the excellent work co-ordinated by Age Concern and its partners throughout last year, which is appropriately entitled "The Debate of the Age."
The experiences of people in Scarborough and Whitby have given me the opportunity to work alongside local members of ARPO50—the Association of Retired Persons over Fifty. Through that dialogue, which rapidly developed a national dimension, the principles behind my proposed legislation became focused on the need for urgent action. My Bill therefore seeks to encourage and support the Government in their fight against age discrimination.
Every hon. Member has first-hand experience or anecdotal evidence of discrimination in the workplace, but the evidence presented to me is more wide-ranging and covers almost every aspect of modern life, such as access to financial services, the national health service, educational opportunity, the voluntary sector, and even everyday occurrences such as attempting to hire a motor car.
A well-known bank has a policy of not lending to people over the age of 65. The reason is the unspoken fear of having to fight the estate if the person dies before the loan is repaid. A certain well-known bank has an age restriction of 65 for telephone banking. The justification is that people over 65 have a problem remembering their PIN number, which is essential for all telephone banking procedures. I could cite many other examples from the financial sector.
A national survey on age discrimination in 1998 found that almost 8 million people had experienced discrimination in employment, and 33 per cent. of over-50s say that they have experienced age discrimination. Studies suggest that the age at which discrimination is experienced is falling. Age discrimination is perceived to start at 42, according to a survey conducted in 1998.
Back in 1975, 95 per cent. of men aged 55 to 65 were in employment. The proportion is now closer to 60 per cent. It is estimated that only one in three people over 40 will be working by the end of this year. A man made redundant in his 50s is 50 per cent. more likely than a working man to die within five years of stopping work.
Age Concern's on-going health campaign has gathered evidence from 2,000 people and their families which shows that, across the board, older people experience discrimination in the NHS. A survey earlier this year found that one in 20 people over 65 feel that they have been refused treatment in the NHS. Almost 2 million—one in 10—say that they have received different treatment since their 50th birthday. I could give much more anecdotal information, but in proposing the Bill, I want to go beyond the anecdotal and the objective by offering a more analytical approach to inform the Government and policy makers of the problems that face every community in the land.
Last weekend, I attended a community fair in Whitby where I was surprised by further first-hand experience of age discrimination. The local scouting group displayed its excellent range of youth activities, but was attempting to recruit a new adult leader. The current leader thanked me for the action that I intended to take today and for raising the issue. When he turns 65 in a few months time, he will be forced to retire from the scouting movement. He is fit, motivated and enthusiastic about working with the younger generation. Seeing him forced out of his voluntary position in a respected, people-focused organisation has left me wondering why that organisation is practising such discrimination, which I am sure the House would wish to reject.
I want the commission to deal with such issues as it attempts to influence policy makers and voluntary organisations. Discrimination in any form disfigures and blights our society. With an increasing number of people approaching the formal age of retirement, it is essential that the size of the problem should be measured so that appropriate community-inspired solutions can be introduced to limit its effects.
My proposal has received wide support across the House. That mirrors feeling across the nation. I hope that my proposal finds favour with the House as it exemplifies what this place should be all about—offering solutions to problems rather than simply presiding over them.

Mr. Desmond Swayne: It is an honour to follow the hon. Member for Scarborough and Whitby (Mr. Quinn), and I pay tribute to him for his passion and eloquence. His command of the statistics showed how thoroughly he had researched the matter.
That said, I must disagree with him. I do not favour commissions of the sort that he wants to create. They would divide our people into competing interest groups, often antithetical to one another. Logically extended, his proposal would leave us with commissions for fat people or for any number of other groups. It is fundamental that the House should act as guardian of the interests and rights of our people. It is for us to advise the Government and hold them to account. We should not set up commissions to take on our role.
The bare-faced cheek of the hon. Gentleman's proposal astounds me. The Government's record on age is breathtakingly at odds with his views. Our nation has, through its institutions, acquired a dignity of age over many centuries, but the Prime Minister has characterised the land as a young country. What sort of message was that supposed to convey? The Government's own supporters have eloquently pointed to their failure in these matters. I draw to the House's attention the words of the hon. Member for Great Grimsby (Mr. Mitchell) in the address and reply debate that opened this Parliament. The hon. Gentleman said:
As this is confession time, I admit that I went away shortly after the election… I came back to find that I am indeed part of an excluded generation—the rising-60s. To paraphrase Wordsworth in "The Prelude": "Bliss was it in that dawn to be alive—but to be old was something of a disadvantage." That is the situation in which I find myself.—[Official Report, 16 May 1997; Vol. 294, c. 304–05.]
The hon. Member for Great Grimsby spoke eloquently for that generation of Labour Members who were beyond the opportunities afforded by those on the Treasury Bench. However, those on the Treasury Bench throughout this Parliament have not acquired the dignity and wisdom of age; they are entirely bereft of it. If the hon. Gentleman's Bill, and the case for it, were to have any credibility, the Government should set an example themselves. Perhaps Labour Members have become so desperate about there being any Government action on the issue that they have had to resort to the motion. The House should deny them the opportunity.

Question put, pursuant to Standing Order No. 23 (Motions for leave to bring in Bills and nomination of Select Committees at commencement of public business):—

The House divided: Ayes 190, Noes 7.

Division No. 264]
[3.56 pm


AYES


Adams, Mrs Irene (Paisley N)
Bell, Stuart (Middlesbrough)


Allan, Richard
Benn, Rt Hon Tony (Chesterfield)


Anderson, Donald (Swansea E)
Berry, Roger


Ashdown, Rt Hon Paddy
Best, Harold


Ashton, Joe
Blizzard, Bob


Atherton, Ms Candy
Bradley, Peter (The Wrekin)


Atkins, Charlotte
Brake, Tom


Baker, Norman
Brand, Dr Peter


Ballard, Jackie
Breed, Colin


Barnes, Harry
Brown, Russell (Dumfries)


Barron, Kevin
Burnett, John


Beard, Nigel
Burstow, Paul


Begg, Miss Anne
Butler, Mrs Christine





Campbell, Rt Hon Menzies (NE Fife)
Ladyman, Dr Stephen



Laxton, Bob


Campbell, Ronnie (Blyth V)
Lloyd, Tony (Manchester C)


Campbell-Savours, Dale
Llwyd, Elfyn


Cann, Jamie
Love, Andrew


Casale, Roger
McFall, John


Caton, Martin
McIsaac, Shona


Cawsey, Ian
McKenna, Mrs Rosemary


Chapman, Ben (Wirral S)
Maclennan, Rt Hon Robert


Chisholm, Malcolm
MacShane, Denis


Clapham, Michael
Mahon, Mrs Alice


Clark, Rt Hon Dr David (S Shields)
Mallaber, Judy


Clarke, Eric (Midlothian)
Marsden, Paul (Shrewsbury)


Clwyd, Ann
Marshall, David (Shettleston)


Coaker, Vernon
Martlew, Eric


Coleman, Iain
Meale, Alan


Connarty, Michael
Michie, Bill (Shef'ld Heeley)


Cook, Frank (Stockton N)
Michie, Mrs Ray (Argyll & Bute)


Corbett, Robin
Moran, Ms Margaret


Cotter, Brian
Morgan, Alasdair (Galloway)


Crausby, David
Morgan, Ms Julie (Cardiff N)


Cryer, John (Hornchurch)
Mudie, George


Cunningham, Jim (Cov'try S)
Murphy, Denis (Wansbeck)


Curtis-Thomas, Mrs Claire
Murphy, Jim (Eastwood)


Dalyell, Tam
Naysmith, Dr Doug


Darvill, Keith
Norris, Dan


Davey, Edward (Kingston)
O'Brien, Bill (Normanton)


Davey, Valerie (Bristol W)
Olner, Bill


Davidson, Ian
Öpik, Lembit


Davis, Rt Hon Terry (B'ham Hodge H)
Organ, Mrs Diana



Osborne, Ms Sandra


Dawson, Hilton
Perham, Ms Linda


Dismore, Andrew
Pickthall, Colin


Dobbin, Jim
Pike, Peter L


Donohoe, Brian H
Plaskitt, James


Doran, Frank
Pond, Chris


Drew, David
Pound, Stephen


Edwards, Huw
Powell, Sir Raymond


Ewing, Mrs Margaret
Prentice, Ms Bridget (Lewisham E)


Fabricant, Michael
Prentice, Gordon (Pendle)


Fitzpatrick, Jim
Prosser, Gwyn


Flynn, Paul
Purchase, Ken


Foster, Don (Bath)
Quinn, Lawrie


Foster, Michael Jabez (Hastings)
Rapson, Syd


Foster, Michael J (Worcester)
Reed, Andrew (Loughborough)


Fyfe, Maria
Rendel, David


Galloway, George
Ross, Ernie (Dundee W)


George, Andrew (St Ives)
Ruane, Chris


Gibson, Dr Ian
Russell, Ms Christine (Chester)


Golding, Mrs Llin
Salmond, Alex


Gorrie, Donald
Salter, Martin


Griffiths, Jane (Reading E)
Sanders, Adrian


Griffiths, Nigel (Edinburgh S)
Sarwar, Mohammad


Griffiths, Win (Bridgend)
Sawford, Phil


Gunnell, John
Sedgemore, Brian


Hancock, Mike
Shaw, Jonathan


Heath, David (Somerton & Frome)
Sheldon, Rt Hon Robert


Hepburn, Stephen
Simpson, Alan (Nottingham S)


Hood, Jimmy
Skinner, Dennis


Hope, Phil
Smith, Miss Geraldine (Morecambe & Lunesdale)


Hopkins, Kelvin



Hoyle, Lindsay
Smith, Sir Robert (W Ab'd'ns)


Hurst, Alan
Squire, Ms Rachel


Illsley, Eric
Starkey, Dr Phyllis


Jenkins, Brian
Steinberg, Gerry


Jones, Rt Hon Barry (Alyn)
Stevenson, George


Jones, Helen (Warrington N)
Stewart, Ian (Eccles)


Jones, Ms Jenny (Wolverh'ton SW)
Stinchcombe, Paul



Stoate, Dr Howard


Jones, Jon Owen (Cardiff C)
Taylor, David (NW Leics)


Jones, Nigel (Cheltenham)
Taylor, Matthew (Truro)


Keen, Alan (Feltham & Heston)
Thomas, Gareth R (Harrow W)


Keen, Ann (Brentford & Isleworth)
Thomas, Simon (Ceredigion)


Khabra, Piara S
Tonge, Dr Jenny


King, Andy (Rugby & Kenilworth)
Trickett, Jon


Kumar, Dr Ashok
Turner, Dennis (Wolverh'ton SE)






Turner, Dr Desmond (Kemptown)
Winnick, David


Turner, Dr George (NW Norfolk)
Winterton, Ms Rosie (Doncaster C)


Tynan, Bill
Woolas, Phil


Vis, Dr Rudi
Wray, James


Ward, Ms Claire
Wright, Anthony D (Gt Yarmouth)


Watts, David
Wyatt, Derek


Webb, Steve



Welsh, Andrew
Tellers for the Ayes:


White, Brian
Mr. Andrew Stunell and


Williams, Alan W (E Carmarthen)
Mr. John McDonnell.


NOES


Blunt, Crispin
Nicholls, Patrick


Bruce, Ian (S Dorset)
Robertson, Laurence


Clark, Dr Michael (Rayleigh)



Gray, James
Tellers for the Noes:


McIntosh, Miss Anne
Mr. Eric Forth and


Maclean, Rt Hon David
Mr. Desmond Swayne.

Question accordingly agreed to.

Bill ordered to be brought in by Mr. Lawrie Quinn, Mr. Jim Murphy, Mr. Michael Fabricant, Lorna Fitzsimons, Mr. Jeffrey Donaldson, Mr. John Grogan, Mr. Douglas Alexander, Mr. Richard Allan, Mr. Stephen Twigg, Ms Claire Ward and Mr. Andrew Reed.

AGE EQUALITY COMMISSION

Mr. Lawrie Quinn accordingly presented a Bill to make provision for the establishment of an Age Equality Commission to advise the Government on discrimination issues in relation to older people: And the same was read the First time; and ordered to be read a Second time on Friday 21 July, and to be printed [Bill 159].

Orders of the Day — Care Standards Bill [Lords]

As amended in the Standing Committee, considered

New Clause 16

GENERAL POWERS OF THE COMMISSION

'. The Commission may at any time give advice to the Secretary of State on—

(a) any changes which the Commission thinks should be made, for the purpose of securing improvement in the quality of services provided by local authorities in England in the exercise of relevant functions, in the standards set out in statements under section 48; and
(b) any other matter connected with the exercise by local authorities in England of relevant functions.'—[Mr. Hutton.]

Brought up, and read the First time.

The Minister of State, Department of Health (Mr. John Hutton): I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker (Mr. Michael Lord): With this it will be convenient to discuss the following: Government amendment No. 53.
Amendment No. 31, in clause 31, page 17, line 6, after "functions", insert "of regulation and inspection".
Amendment No. 96, in clause 44, page 22, line 40, at end insert—
'(1A) The description of premises referred to in paragraph (1)(b) does not extend to the private dwelling-house of a foster parent'.
Amendment No. 3, in schedule 1, page 84, line 3, at end insert—'Committees and Directorates—
6A. The Commission shall establish—

(a) an Independent Healthcare Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of independent hospitals; and
(b) a Nursing and Care Homes Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of nursing and care homes.


6B. The Commission shall establish—

(a) a Directorate of Independent Healthcare under a Director of Independent Healthcare, who shall report to the Independent Healthcare Committee; and
(b) a Directorate of Nursing and Care Homes under a Director of Nursing and Care Homes, who shall report to the Nursing and Care Homes Committee.


6C. The Secretary of State may by regulations define the respective responsibilities of the Committees established in accordance with paragraph 6A.'.
Amendment No. 32, in page 84, line 3, at end insert:—'Healthcare Committee—
6A. The Commission shall establish a Healthcare Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of independent hospitals.
6B. The Secretary of state shall appoint a Deputy Chairman of the Healthcare Committee from the staff of the Commission for Health Improvement ("CHI"), and the Deputy Chairman shall have


specific responsibility for ensuring that the system of inspection of independent hospitals is common and comparable to the system used to inspect NHS hospitals.
6C. The Secretary of State may by regulation define further specific responsibilities of the Committee established in accordance with paragraph 6A.'.
Government amendment No. 82.

Mr. Hutton: In Committee, the hon. Member for Runnymede and Weybridge (Mr. Hammond) tabled a similar amendment, which would have allowed the commission to advise the Secretary of State on national minimum standards and other matters relating to part III services. I accepted the principle of the amendment but was unable to accept the wording. I am happy to put this more suitably worded new clause before the House.
The new clause is similar in effect to clause 7(5), which gives the commission the power to provide the Secretary of State with any information that it thinks would improve the quality of part III services, as defined in the Bill. The clause allows the commission, in the course of fulfilling its inspection role, to report to the Secretary of State if changes need to be made to the national minimum standards to secure improvements to local authority fostering and adoption services, and on any other matter connected with the exercise of these functions.
Through its inspection of local authority fostering and adoption services, the commission will be able to make a judgment on how effective the standards are. It is important that it should be able to pass on advice that would improve the quality of these services to the Secretary of State. This will ensure the continuing improvement of standards across the country. The Government are strongly committed to that. I thank the hon. Gentleman for raising this issue, as that will be an important function for the commission.
On amendment No. 53, the hon. Gentleman tabled an amendment in Committee that would have had the effect of requiring Ministers to publish the reports of all inquiries held under clause 10. As I made clear to the hon. Gentleman in Committee, we certainly intend to publish the inquiry reports. It is crucial for the public to have confidence in the commission and in the services that it is regulating. It is clearly desirable for failings in those services, or in the regulatory system, to be open to public scrutiny, so that lessons can be learned for the future.
The amendment makes it absolutely clear that all inquiry reports will normally be published, but allows the Government to withhold publication in exceptional circumstances only. As hon. Members will appreciate, there could conceivably be rare instances in which it would not be appropriate to publish a report—if, for example, it included unproven allegations against an individual that could possibly be interpreted as being defamatory. I hope, however, that that will never happen, and that it will be possible to publish all reports.
Let me now deal with amendment No. 82. The Government have made it clear throughout that they intend the commission and the councils to employ their own staff, and intend their functions normally to be carried out by members of their staff. On occasion, however, they may need to sub-contract work to outside people and organisations. For example, the commission may on occasion need to contract some of its inspections to self-employed inspectors if its own inspectorate is

reduced owing to illness or a sudden surge of vacancies, although I hope that such problems will not occur. More important, however, the commission may want to contract specialist expertise to help it in its inspection function. It may, for instance, want to contract an NHS trust to provide specialist pharmaceutical advice. Similarly, the councils may wish to contract an outside organisation to provide them with specialist advice.
The purpose of this amendment to paragraph 13 of schedule 1 is simply to ensure that the commission and the councils have the power to sub-contract work, in an entirely sensible and pragmatic fashion.

Mr. Philip Hammond: It is perhaps fitting for us to start with a Government new clause that reflects our constructive discussion in Committee. On a number of occasions the Opposition tabled amendments that the Government could not accept—sometimes for drafting reasons, sometimes because they were not entirely happy with the precise way in which the Opposition had sought to amend the Bill—although they were willing to accept the principle.
Although, in the true traditions of this place, we had heated discussions on some issues, by and large the Committee engaged in constructive consideration, which has led to significant changes. I believe that some 37 of the Government amendments and new clauses with which we shall deal today respond to issues raised by Opposition parties in Committee. The Government have reshaped those ideas into a form acceptable to them, and we appreciate that.
New clause 16 gives the National Care Standards Commission a role in relation to the functions of local authorities which mirrors the role that the Bill gives it in clause 7(5) in relation to what it describes as part II services. The clause allows the commission to act as the Secretary of State's eyes and ears—to advise him on changes that might be required to national minimum standards in order to secure improvements in the delivery of services.
As the Minister has acknowledged, we proposed such a measure in Committee. We referred to part III services, thinking that that would nicely reflect the reference to part II services in what is now clause 7. Sadly, however, while part II services are defined, part III services are not. The Minister therefore rightly described our proposal as defective, but, following consideration, has presented a way of achieving the objective within the confines of the definitions in the Bill. "Relevant functions" in relation to local authorities is defined in clause 43.
4.15 pm
During discussions in Committee on the role of the National Care Standards Commission, particularly in providing information and advice to the Secretary of State, we expressed the view that it would be good if the commission could be a watchdog out and about among providers and users of services, and if it were able to flag up issues to the Secretary of State, quite apart from any areas where the Secretary of State might specifically require it—as he has the power to do—to investigate a matter and to report back. In other words, it might instigate such investigations itself.
To give that role of watchdog, it would be necessary for that information to be published and widely known, so that people outside were aware of the concerns that the


commission had identified and had reported back to the Secretary of State. We would have preferred a provision that required publication of the advice given to the Secretary of State in order to stimulate public debate.
The Government were not prepared to concede that point. We had that argument and lost it. That somewhat limits the power of the care standards commissioner to flag up problems effectively for public scrutiny. Nevertheless, new clause 16 is a worthwhile extension to the powers and capabilities of the commission and we welcome it. I am grateful to the Minister for taking the time and trouble to redraft what we originally tabled and to bring it forward for inclusion in the Bill.
Government amendment No. 53 deals with a slightly different issue that touches on some of the same concerns. I mentioned in relation to new clause 16 our preference for advice that was given to the Secretary of State to be published, so that it was available for public scrutiny. The amendment addresses a concern raised in Committee about the publication of inquiry reports. It makes it clear, as the Minister has said, that the norm will be that such inquiry reports will be published in a manner determined by the Minister. He has reserved for himself the power in exceptional circumstances not to proceed with publication.
Again, in Committee, we sought to change that arrangement, so that it would be the person conducting the inquiry who determined whether the report should be published and, indeed, the mode of publication. The Minister was not able to agree with us on that point, but he acknowledged then that he expected the norm to be publication and that publication would be withheld only in exceptional circumstances.
The amendment meets the Government's commitment in Committee to provide for that point on Report. The Minister gave us one example of what he might consider to be an exceptional circumstance: a situation where the contents of a report might be considered libellous. I had thought that he probably had in mind a situation where criminal proceedings might be contemplated and the material in the report might prejudice those proceedings and, thus, be inappropriate for publication at that time. I hope that he will acknowledge that in a case where, for example, criminal proceedings are contemplated, there is an argument for delaying publication of an inquiry report in order to allow those criminal proceedings to continue uncompromised by publication of the report. However, I suggest that, in those circumstances, it would be in the public interest that the report was published eventually.
I can think of very few circumstances beyond the one that the Minister mentioned in which it would be appropriate not ever to publish. Even the circumstances that the Minister mentioned might be an argument only for delay, until the matters giving rise to the possible libel had been resolved.
I should be grateful if, later in the debate, the Minister will say whether the libel situation that he intimated and the possibility of criminal prosecution are the only situations in which he envisages immediate publication not being possible, and also whether he agrees that, in the case of pending criminal proceedings, it would be possible for the report to be published eventually, at an appropriate time.
The Liberal Democrats' amendment No. 31, which was tabled by the hon. Members for Sutton and Cheam (Mr. Burstow) and for Isle of Wight (Dr. Brand), seeks to tighten the commission's power to require disclosure of any information that it considers to be "necessary or expedient"—I emphasise those words—
for the purposes of its functions.
The amendment would tighten that power by making it clear that subpoenas can be used only in relation to material that is "necessary or expedient" for the purposes of the commission's functions of regulation or inspection.
I expressed a concern in Committee that I am sure Liberal Democrat Members share—amendment No. 31 expresses a similar concern—but I am not sure that their amendment, albeit well meaning, really deals with the mischief that concerns us. The real concern that we expressed was that the Bill enables the care standards commission to conduct fishing expeditions—to seek information from registered persons without necessarily having to indicate a specific reason why it needs that information, and perhaps even to trawl widely in the hope of finding something that might incriminate the person or persons in question, leading ultimately to the deregistration of those people or that establishment.
In this debate, it is important for us to explore with the Minister how he intends to prevent the commission from undertaking that type of fishing expedition. Perhaps he will be able to reassure us that he can use the extensive regulation-making power that the Bill gives to the Secretary of State to prevent that type of activity.

Mr. John Bercow: I think that my hon. Friend will recall that on Second Reading I inquired about the nature of the regulations that will be introduced attendant upon the Bill. Is he satisfied that any regulations on this subject will be subject to the affirmative procedure, and therefore open to hon. Members to debate?

Mr. Hammond: Regulations made in relation to this aspect of the Bill, and to the great majority of the Bill, will be subject to the negative procedure.[Interruption.] While I understand that my hon. Friend is quite naturally disappointed about that, I have to tell him that it gets worse.
In the next group of amendments, we shall be examining a subject on which significant material will be introduced by Ministers, not in the form of regulation subject to either the affirmative or the negative procedure, but in the form of documents that will not be subject to any form of parliamentary scrutiny. I hope that my hon. Friend will be in the Chamber for that debate, when he will be able to explore that issue a little more fully.
In Committee, concerns were raised about the powers that the National Care Standards Commission will have to obtain information from a registered person. The Bill does not appear to include any exclusion for information that a registered person is gathering in contemplation of an appeal against a decision to deregister under the procedures in the Bill. I raised that issue with the Minister who, to paraphrase his response, agreed that it would not be acceptable for the commission to seek to sequester the evidence that an individual intended to produce to an appeal tribunal merely because it would be expedient for the commission to do so. Of course it would always be expedient to have sight of an opponent's intended evidence in any proceedings.
The Minister made it clear that he did not contemplate such wide-ranging use of the power, but nothing in the Bill would prevent such action. Perhaps the Minister will prevent it through regulation, but I am certain that the hon. Member for Sutton and Cheam (Mr. Burstow) had such issues in mind when he framed his amendment. I am sure that he will wish to pursue the argument further, if he is fortunate enough to catch your eye, Mr. Deputy Speaker.
Amendment No. 96, tabled by myself, addresses clause 44, which deals with the power of entry of inspectors. The issue at stake depends on the interpretation of the term in the clause about
premises which are used…by a local authority in its discharge of relevant functions.
Relevant functions are defined as functions of fostering and adoption and the clause gives powers of entry to premises that are used in that connection. If that means a power of entry to the town hall to have a look in the filing cabinet, at any time of the day or night and without notice—although we might have practical issues to raise—nobody would have a problem in principle with inspectors inspecting the premises of a public authority to ensure that records are in order. However, the advice that we received before the Committee debate on the subject was that it is not clear from the Bill's wording that the term does not include the private dwelling house of a foster parent who fosters a child for the local authority. Fostering is a relevant function and the local authority is procuring the discharge of that function. It is at least arguable that the private dwelling house of the foster carer is a premises being used in the discharge of that relevant function. I return to the issue today because the Minister sought to deal with the concerns during the debate.

Dr. Peter Brand: Does the hon. Gentleman believe that no powers of entry should be granted for the private dwellings of foster parents? Under existing arrangements and for the purpose of child protection, surely it is important that inspections can be made.

Mr. Hammond: The hon. Gentleman is right. As he says, inspections can be made under existing legislation and will continue to be possible. If he will bear with me for a moment, I shall come to that point.
Let me quote from an exchange in Standing Committee. I said to the Minister:
My reading of the Bill was that the reference in subsection (1)(b) to premises used by a local authority in the discharge of its relevant functions would include the private home of a foster carer, where a child is being fostered as part of the discharge of the local authority's functions. Will the Minister say whether that is correct?
The Minister replied:
Other amendments are coming up that will allow us to discuss that. There will be an opportunity for National Care Standards Commission inspectors to have access to the homes of private foster carers, because that is entirely appropriate.

I then asked the Minister the same question again:
Will the Minister answer my specific question? Does the reference in subsection (1)(b) to premises used by a local authority for the discharge of its relevant functions include a private home in which a child is fostered?
The Minister answered
My advice is that it does not include the private homes of foster carers.—[Official Report, Standing Committee G, 22 June 2000; c. 428–29.]
I have got to know the Minister quite well during the progress of this Bill and others. When he prefaces a remark by saying, "My advice is", that suggests that he has just a little doubt in his own mind, as when he is quite clear about something he is usually robust in saying so. Apparently, there is something of a contradiction between those two statements. The Minister said that there would be an opportunity for National Care Standards Commission inspectors to have access, but clearly that opportunity will not occur under clause 44. We need to hear from the Minister where it is stated in the Bill that National Care Standards Commission inspectors will have access to the private dwellings of foster parents.
To answer the hon. Member for Isle of Wight (Dr. Brand), of course local authorities, as part of their contracting process, may require access to the private dwellings of foster carers. They may want to secure that access for National Care Standards Commission inspectors. I have no problem with that as it would be a contractual matter, and issues such as time of access and how much notice needs to be given could be agreed between the parties to the contract. That is quite distinct from a statutory power of entry.
The amendment seeks to clarify what I think the Minister told me in Committee—that a private dwelling is specifically excluded from the definition of premises used by a local authority in its discharge of relevant functions. We believe that there is an important distinction to be drawn between the domestic dwelling of a private individual and premises such as the offices of a local authority.
In addition, again referring to what the hon. Member for Isle of Wight said, there will still be powers of entry in certain circumstances—for example, to protect the safety of children under the Children Act 1989, although that power would probably not be exercisable by National Care Standards Commission staff. So, both through contracting and through the existing legislation for the protection of children, there would be access, but I am still baffled by the Minister's reference in Committee to the right of National Care Standards Commission inspectors to have access to private dwellings, and I look forward to some clarification on that point.
Amendment No. 3, in my name and that of my hon. Friend the Member for Meriden (Mrs. Spelman), deals with the inspection of independent acute health care provision. This matter considerably exercised my noble Friends and others when the Bill was being considered in another place. I cannot speak for my noble Friends and other noble Lords as to how they might proceed when the Bill returns to them stripped of the provisions that they inserted on inspection of the independent acute health care sector.
The Bill originally contained provisions that would have made the Commission for Health Improvement responsible for inspection, registration and regulation


of the independent health care sector and the NHS. The Government have advanced some persuasive and largely pragmatic arguments why the commission would not be appropriate for the task. They said that it was designed with a different purpose in mind, and to work in the context of a managed service—the NHS—rather than in an independent system that requires arm's-length regulation.
The debates on the matter have caused much rethinking on the issue by hon. Members of all parties. However, it is clear that the Government oppose the use of the Commission for Health Improvement as a single regulatory body for both independent and NHS provision. When Conservative peers pressed for that, they were keen to draw attention to the advantages—a level playing field and a clear and even-handed regulatory system that would ensure that patients were treated in accordance with appropriate and properly policed standards. That would be the case wherever they were treated and whoever was paying for the treatment.
It is becoming increasingly ludicrous to distinguish between the private and NHS sectors. The Government have made clear their intention to use private-sector providers more regularly and widely in the provision of care to NHS patients. The Government tabled a new clause in Committee to allow cross-contracting between the Commission for Health Improvement and the National Care Standards Commission, to avoid the absurdity of double inspection, under which beds are inspected separately according to whether they contain NHS or private patients.
One anomaly remains, however. Many private beds remain in the NHS, and they will still be inspected by the Commission for Health Improvement, rather than by the National Care Standards Commission. The independent acute provision sector will be regulated and registered, but its largest competitor—the NHS pay beds service—will not.
Our preference would be for a single regulatory mechanism covering all sectors, but the Government will not countenance that. The independent sector and other observers have described the problems that they foresee, and we propose that two separate committees and directorates should be established in the National Care Standards Commission. Each would be led by a dedicated commissioner, who would be the figurehead responsible for, respectively, independent acute health care and for nursing and care homes. That recognition would give clear status to the importance of those two strands.
The commission is a multi-functional body. We are dealing with two areas in which, by definition and by circumstance, large elements of the total provision come from the independent sector.

Mr. Tim Collins: My hon. Friend makes a powerful case for amendment No. 3. Could he, for my benefit, and possibly that of other right hon. and hon. Members, clarify whether the commissioners who would have those specific tasks would be appointed by the Secretary of State or the chairman of the commission? Would they be appointed to the commission with a view to having a specific

responsibility, and does my hon. Friend therefore envisage that people with a specific background would be appointed?

Mr. Hammond: I believe that the Bill provides that the Secretary of State will appoint the commissioners. Interestingly, amendment No. 32, tabled by Liberal Democrat Members, addresses my hon. Friend's point by suggesting that a member of the Commission for Health Improvement staff should be the deputy director of the independent health care directorate of the National Care Standards Commission. That issue is likely to be debated shortly.
Why is it necessary to establish a separate entity within the commission to address the needs and concerns of the independent acute health sector? A couple of general points have come to light, as well as a couple of specific points. First, which staff in the commission will carry out the inspections and the registration function? We believe, from what the Minister has told us, that many of them are carrying out inspection functions within health or local authorities, and will move across to the National Care Standards Commission.
In some areas—I emphasise "some"—there are historic tensions that do not bode well for a good working relationship. The old role of inspectors working within local or health authorities is different from the working relationships that the Government hope to inspire by this new model, in which people will work for an independent care standards commission. There is a concern in the independent sector that the same people will be wearing different hats—and probably earning higher salaries—after the move from one employer to another.
There are specific questions about the nature of inspection and the regulation of private hospitals. The term "independent hospitals" encompasses a wide range of entities. Sophisticated hospitals in central London and other large cities have sophisticated equipment, fully-fledged intensive care beds and the capability to carry out almost any procedure that can be done in the national health service. At the other end of the scale we have smaller, low-tech institutions. The smaller ones are often run by voluntary or charitable organisations; they may perform a general service to the community or to a particular group or community.
There is a wide range of competence and ambition between private hospitals. We must ensure that the regulation and inspection regime is sensitive to those differences, and that small hospitals seeking only to carry out relatively minor procedures are not rendered non-viable by a requirement to comply with regulations designed for hospitals that have loftier ambitions.
We agree with the industry that identifying a unit within the National Care Standards Commission that will address itself exclusively and specifically to these issues, will give a greater chance of achieving an appropriate, light-touch regime that will ensure proper delivery of consistent quality standards and proper compliance with appropriate levels of regulations without becoming oppressive. That is why we propose the establishment of the health care committee, and an associated commissioner.
I turn to the arguments for the nursing and care homes committee. In some cases, history does not offer much help when we consider working relationships in


that sector. Local authorities have been providers of accommodation themselves, as well as purchasers of accommodation and services from the private sector and regulators of that sector. They have experienced considerable conflicts of interest, because they are asked to regulate homes that are in competition with those that they provide. There are many stories from many parts of the country about practices that we certainly should not accept. I know that the Minister would not accept them; that is, in large part, why the Government want to change the regime and to establish a level playing field.
4.45 pm
The Bill will separate the role of regulator from that of provider. For the first time, it will require local authorities that provide care home or nursing home accommodation to be regulated in the same way as their private sector competitors. We acknowledge that the establishment of that regime is an important element of the measure, and we welcome it.
People who are active in the sector are anxious about the fact that those with whom they have, with difficulty, built relationships on specific issues locally will arrive on their doorsteps as the inspectors for the National Care Standards Commission. Although everyone might be working on the new level playing field that the Government are creating, we all know that it is easier to change a title than to deal with deep-rooted, long-established personality differences that have grown up over a long time.
As the Minister acknowledged in Standing Committee, in some cases there will be real difficulties in ensuring that there are constructive working relationships between the commission inspectors and the providers of residential accommodation. Much confidence building and tender loving care will be needed to convince all the providers that the new regime genuinely represents a break with the past and with a system that many people feel is discredited. A dedicated commissioner and committee would send the right signals—a positive message to encourage all parties to build constructive relationships in the future.
The aims of the Liberal Democrats' amendment No. 32 are closely linked to those of amendment No. 3. An interesting twist in amendment No. 32 is that it provides for the appointment of a deputy chairman from the staff of the Commission for Health Improvement. I realise that the provision was designed to ensure that the committee includes a member with expertise in acute health care—indeed, that it is led from the top, or near the top, by such a person. That would address the fear expressed by those in the independent acute sector that their needs might be swamped by the broader responsibilities of the National Care Standards Commission for registering and regulating care homes. I anticipate that there will be certain practical problems with the Liberal Democrats' proposals, but I look forward to hearing the detailed reasoning for their approach to a problem that we have both identified. Their amendment deals with concerns that we share.
The Government have embarked on the creation of a level playing field for care home regulation and registration. In Committee they made a minor concession in relation to boarding schools, and made it clear that they did not want a distinction between independent and local

authority schools. That was another step in the right direction, but we have come to a deeper philosophical divide in relation to acute hospitals.
The Under-Secretary, the hon. Member for Birmingham, Edgbaston (Ms Stuart), said openly in Committee that the Government were committed to the managed system of health care and to the Commission for Health Improvement, which has no power of deregistration. If it finds a problem in the national health service acute sector, all that it can do is report the problem to the management—which may be responsible for the problem in the first place. It will have to rely on the Secretary of State's powers for direction and central management of the national health service to try to deal with the problem. In the independent care sector, the National Care Standards Commission will have real teeth, because it will be able to deregister someone who is in breach of the standards or who has not behaved properly in any other way.
Our amendment and the Liberal Democrats' amendment seek to address the real concerns of the independent health care sector and to make the level playing field a reality. The amendments recognise that both sectors—the independent sector and the national health service—can learn from each other. There is not a monopoly of wisdom on either side, and no one thinks that there is.
The amendments will help to ensure—there is no guarantee—that independent sector providers are not saddled with inappropriate registration or inspection regimes, and that the many different functions of independent hospitals are properly recognised. The industry believes that there would be safety in having a dedicated commissioner, and amendment No. 3 seeks to provide for one. The Liberal Democrats have a similar aim in amendment No. 32.
In a letter to me dealing with outstanding matters from the Committee, the Minister described Government amendment No. 82 as a drafting amendment. However, as he said in his opening remarks, it addresses the question of how the National Care Standards Commission will operate. Will it mainly employ its own staff, or contract its functions out? In other words, will it follow the local authority or the Ofsted model? Will the initial position be enshrined in any way or may it change over time? Does the Minister envisage the position evolving once the initial cohort of staff, who will transfer from local authorities and health authorities, is replaced by other people? Members on both sides of the House will wish to explore that issue a little so that they can understand the significance of the change that the amendment will make to schedule 1.
This interesting and diverse group of amendments and new clauses will significantly improve the Bill—and I include the Government new clause and amendment in that description. I look forward to hearing in due course the Minister's answers to my questions.

Mr. Paul Burstow: I look forward to the contribution of the hon. Member for Chatham and Aylesford (Mr. Shaw). The hon. Member for Runnymede and Weybridge (Mr. Hammond) said that he looked forward to the Minister's response in due course, and it remains to be seen how long, and how detailed, that turns out to be, as I know that some Members are minded to engage in a detailed dialogue on these matters.
The Government amendments are wholly welcome and useful additions to the Bill, and rightly respond to concerns that were raised by Members on both sides of the Committee. The hon. Member for Runnymede and Weybridge broadly welcomed amendment No. 31, which we tabled and to which my hon. Friend the Member for Isle of Wight (Dr. Brand) will speak in some detail. When he does so, we shall see whether the amendment involves the degree of paranoia that was suggested might underpin it. My hon. Friend and I wish to ensure that the Minister addresses concerns on that matter.
I wish to concentrate on amendment No. 32 and shall comment in passing on amendment No. 3, which was tabled by the hon. Member for Runnymede and Weybridge. Both amendments deal with the same issue, as the hon. Gentleman and I, as well as many other Members, are trying to find a route by which we can create a common architecture for establishing a sensible regime of standard setting across the health sector, regardless of whether services are public or independent. Our discussion is part of a long-running debate—indeed, I suspect that the Minister sometimes thinks that it has been running for far too long—which started with consideration of the Health Act 1999, when we had detailed discussion in Committee and on the Floor of the House about the role of the Commission for Health Improvement, and which continued with the progress of the Bill through all its stages in the Lords and in this place.
It has begun to feel a bit like trench warfare, as there are two clearly defined positions, one on whether it is possible to establish a common framework in which health care standards are set and assured and the other on whether we have to have two parallel or separate structures to do that. To be fair, the Government have moved quite a long way from the position originally taken by the right hon. Member for Holborn and St. Pancras (Mr. Dobson), the former Secretary of State. When the Select Committee on Health conducted an inquiry into the regulation and inspection of the private health care sector, the former Secretary of State responded to a question from my hon. Friend the Member for Isle of Wight by saying that it was not the role of Government to provide a stamp of approval for the private sector.
Clearly, things have moved on, and the Government recognise that there is a legitimate role for Government in providing a mechanism to give the public assurances and guarantees of standards wherever they receive health care. We welcome that movement, which has continued with the passage of the Bill through this place and the House of Lords. When the Bill was published, it was plain that the National Care Standards Commission would have a role in private health care, but that that would be clearly separate from the NHS. CHIMP was not to have a role in private health care because, as several Ministers said, CHIMP is a tailor-made institution, geared to dealing with the specific circumstances of the NHS, which is a managed service. By contrast, they said that private health care services needed to be brought into a regulatory framework. Somehow, those two things were completely different and could not be brought together in a single structure.
Since then, however, in the other place, a majority of their lordships decided that the Bill was defective and a clause was added which would have given CHIMP a specific role in providing, on behalf of the NCSC, inspection and registration of the independent sector. That new clause was subsequently removed in Committee, much to the regret of my hon. Friend the Member for Isle of Wight, myself and many people outside the House.
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We are particularly concerned that the Bill remains silent on the question of a duty of quality that will apply across the board, and not only to the NHS, in respect of which we have debated the rightful need for such a duty to exist. A similar, comparable standard should be applied to the private sector. The Government should now make further moves on that, and even if we cannot affect their actions in this debate, I hope that when the Bill returns to the other place, their lordships will closely examine our debates in Committee and on Report and give the Government an opportunity, by way of an amendment, to think again about how they can provide a consistent framework.
There is no difference between a medical intervention in the private sector and one in the NHS—how can there be? I do not understand how clinical governance can be relevant in the NHS but irrelevant in the private sector. We were told that clinical governance was irrelevant in the private sector because it was defined only in regulations and not in a Bill. Surely it is not beyond the wit of the Government to find a mechanism to provide such a definition so that there is clarity about what clinical governance means in the private sector. It should mean exactly the same as it does in the NHS.
The same applies to clinical management of patients. Surely that also requires common standards. That would be common sense, and we still do not understand why the Government are not prepared to put in place the mechanisms that will guarantee those common standards for everyone in this country.
As I said, the Government's case is that the NHS is a managed service, but the private sector is not and has to be regulated in some form. However, the NCSC will be regulating managed services provided by the public sector, such as boarding schools and colleges, and care homes run by local authorities. Why is it that those institutions, which are provided for and managed by the public sector, have to be regulated and inspected, but the NHS, which is also provided for and managed by the public sector, is not to be regulated and inspected in the same way? What is the difference? Is it simply that the Government are not prepared to trust local government in this respect? What is the difficulty that means that the Government want to twist the logic of the case for a seamless system and have a two-tier system instead?
The Minister has not explained that, and in Committee his colleagues did not adequately address that conundrum, which is at the heart of the Bill. Amendment No. 32, in my name and that of my hon. Friend the Member for Isle of Wight, is intended to provide a vehicle for debate about that and to give the Government a chance to reflect further on what mechanisms could be put in place to use the skills and resources that will be at the disposal of the


Commission for Health Improvement to ensure that we are monitoring and driving up standards in the private sector.
The hon. Member for Runnymede and Weybridge did an admirable job of explaining the purpose of that amendment, so I will not say much more about it. I am grateful for his broad support. Amendment No. 3 in his name takes a similar approach in trying, albeit by a very different route, to provide a structure that would bring together the two sectors.
Ideally, the Commission for Health Improvement should be an arm of the NCSC. That would be logical and it would provide a better fit if we are to have a system that covers the independent sector and the public sector. When one considers that there are more than 200 hospitals in the private sector with more than 10,000 beds, and that last year, there were some 800,000 treatments in that sector, it makes no sense to exclude those treatments from a regime that guarantees standards. That is why we think that one regime with one set of standards and a common understanding of clinical governance would be far better than two separate regimes. In a sense, our amendment is about establishing a vehicle through the NCSC that will achieve that—albeit by dint of setting up a committee. Committees might not be the best vehicle, but they are a means of persuading the Government to consider the matter further.
If we have two separate regimes, as we will under the Bill as drafted, there is immense potential for grey areas to engulf the issues of who has responsibility for the inspection of services, where the line should be drawn between acute and chronic care, and which body has responsibility for the public and the private sector. What if an NHS patient is taken into the private independent sector? Does the inspection regime follow the patient, or does it depend on which bed they occupy when receiving treatment?

Mr. Hammond: Does the hon. Gentleman agree that the Government's introduction into the Bill of clause 7, which allows cross co-operation between the Commission for Health Improvement and the NCSC, averts some of the more bizarre possible outcomes while doing nothing to address the fundamental issue?

Mr. Burstow: I agree absolutely. The hon. Gentleman allows me to acknowledge that, to some extent, the Government have changed their mind and addressed the concerns raised by Opposition Members and Cross-Benchers in the Lords. It is right to establish a mechanism whereby cross-contracting can take place. However, we want to go further—hence our amendment and our argument that, instead of allowing the possibility of contracting to take place between the two agencies, the Government should recognise the necessity of doing so, or—better still—make CHIMP part of the NCSC.
Barring a miracle, it is unlikely that we shall be able to gather enough votes today to persuade the Government to accept either amendment No. 3 or amendment No. 32, but there is a possibility of our doing so in the other place. I hope that, when their lordships give the Bill further consideration, they will agree with Opposition Members that the matter is one that should not be left as it stands, with the Government amendments made in Committee, and that there is a long way to go before the public can

be guaranteed common standards of care wherever they happen to be treated, whether in the independent health care sector or the NHS.
That is what the public now want. When told that there are to be two separate regimes governing the quality and standards of care that they receive, the public are horrified. They want guarantees, continuity and standards that can be assured throughout the health sector. That is what the amendment is designed to achieve. I hope that the Government will accept it, but, if they do not, we hope that the Lords will do more.

Mr. Jonathan Shaw: I welcome new clause 16. I hope that my hon. Friend the Minister of State will be able to advise me whether one of the matters that the commission may consider is private fostering. In Committee, I tabled an amendment requiring those individuals who carry out private fostering to be registered with the commission. I did so not only because of my personal experience, but because Sir William Utting referred to the matter in his report, as did former social services inspector Lord Laming during the Lords consideration of the Bill, and the social services inspectorate in 1994: all called for those who privately foster children to be regulated. However, because the arrangement is a private one, under the provisions of the Children Act 1989, such individuals merely have to notify the local authority that they are looking after children. Many eminent reports have stated that that does not meet the safeguards that we would want for particular children. We do not know how many children are privately fostered, often for a small amount of money. There will be far tighter regulations for day care, where children go home at some part of the day, than for children who may be with private foster carers for weeks, months or years.
My hon. Friend the Minister said that he took the matter seriously. He repeated the response of my noble Friend Lord Hunt of Kings Heath that the social services inspectorate was also be taking the matter seriously and would be requiring local authorities to have greater regard to the responsibility to ensure that private foster carers notify local authorities so that they can be inspected. It has been repeated that there will be a national publicity campaign to ensure that people are aware of their responsibilities.
Suppose that, following the national publicity campaign and the requirement on local authorities, the NCSC, perhaps in consultation with the social services inspectorate, was more rigorous in ascertaining how many children were in private foster care and whether they were being cared for to a standard that we would expect. Would the sharing of that information, if the NCSC raised concerns with my hon. Friend, lead him to introduce legislation of the sort suggested in my amendment, which has been recommended by distinguished Members of the other place who have long experience in these matters? Would my hon. Friend be able to make changes to the foster regulations under the Children Act 1989, or would he have to introduce primary legislation?

Mr. Eric Forth: Those of us who did not have the honour and privilege of considering the Bill in Committee now have the chance to express our thoughts about the Bill, including the matters immediately before us. I make a preliminary observation. My heart sinks whenever I see a Bill like this one and


whenever I hear the dialogue that has already taken place, which is a sort of throat clearing for the main business that is to come.
I am not surprised that we are already in something of a tangle with this group of amendments. I shall say a few words and ask a few questions about each one. We are in a world in which both the Government and the official Opposition claim repeatedly to be deregulatory, to believe in a free society and to wish to dismantle red tape and bureaucracy—I do not know whether the Liberal Democrats sign up to that—yet we are confronted with a Bill that will have precisely the opposite effect.
I accept that on Second Reading and in Committee, it was agreed that there was a need to adopt the approach that is set out in the Bill. I do not intend to challenge that for the moment. That is also a preliminary observation. It is no surprise to me, however, that Members then become hopelessly bogged down when considering the minutiae of what the bureaucracy that we are now setting up will do. One would have thought that its aims were clear enough, but what will it do in detail? The new clauses and amendments that have already been touched on illustrate well how one can set up a well-meaning bureaucracy, but get into difficulty in defining not necessarily its aims, which can usually be pretty well defined, but the way in which the aims will be fulfilled.
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New clause 16 is pretty opaque to say the least, certainly to the layman coming to it for the first time. On the face of it, it should be relatively straightforward. It refers to section 48, but if one goes to clause 48 for guidance and clarity, one is surprised to see that it refers to section 23. Clause 23(1) states:
The appropriate Minister may prepare and publish statements of national minimum standards applicable to establishments or agencies.
That is clear enough. Subsection (2) states:
The appropriate Minister shall keep the standards set out in the statements under review and may publish amended statements.
Subsection (3) states that
the appropriate Minister shall consult any persons he considers appropriate.
The Minister will undoubtedly be able to help us later, but given that the Minister
shall keep the standards…under review
and
shall consult any persons he considers appropriate—
not our old friend may, but shall, which is strong and prescriptive—I should have thought that, without any doubt, that means that the Minister will involve the commission in the review of national minimum standards.
Yet new clause 16 states:
The Commission may at any time give advice to the Secretary of State on…any changes which the Commission thinks should be made.
I shall come in a moment to consider the commission's terms of reference—to look, as it were, through the other end of the telescope—but any reasonable person would be satisfied that, given clauses 48 and 23, the Minister

would be most unlikely to discharge those elements of his responsibilities without fully taking the commission's views into account.
Therefore, because of the obligation that I am assuming, the first question that arises is whether new clause 16 is otiose. The Minister may tell me later that I am wrong in that presumption, but, for the moment, I think that a reasonable person would want to take that view.

Mr. Hammond: My right hon. Friend may not yet have had a chance to look ahead to new clause 4 in the next group of amendments, but, if he does, he will see that it puts precisely that obligation on the Secretary of State, before bringing forward any new standards under what will be a replacement for clause 23—that he must consult and seek certain information from the commission.

Mr. Forth: I am grateful to my hon. Friend for that. I am a slow reader, so I have not quite reached that point yet. I shall want to look at it and listen to what he says at the appropriate time.
I am even more puzzled because in clause 7, entitled "General duties of the Commission", subsection (5) states:
 The Commission may at any time give advice to the Secretary of State on—

(a) any changes which the Commission thinks should be made…and
(b) any other matter connected.


I should have thought that that gives an extraordinarily wide—almost certainly rightly wide—remit to the commission to give advice to the Secretary of State. Yet new clause 16 seems to be in the business of gilding lilies, saying:
The Commission may at any time give advice…under section 48.
We need some clarification. I fear—this is my suspicion about this group of amendments, as I suspect it will be about the next group when I catch up with the reading that my hon. Friend has set me—that when we get into this, we will begin to see that we are wading not just knee deep, but waist deep in a mass of verbiage which, if we are not careful, will obscure the objectives, with which everyone appears to agree, of the new bureaucracy.
That is, of course, the danger. Bureaucracies are bad enough as they are, and rarely achieve the ends that are set. Goodness knows, one can point to any number of examples in other walks of life where there are bureaucracies, commissions and regulatory regimes that hopelessly fail to fulfil their task. One hopes that that will not be the case with the Bill, but I, for one, do not set out with any great optimism.
My problem with new clause 16 is that I cannot for the life of me see how it adds materially and usefully to the wording in the Bill.
In Government amendment No. 53, we are in the "exceptional circumstances" business. The amendment refers to the publication of material and whether that should be done routinely. Again, I accept that the Minister tried to be helpful in his brief explanation. I can understand that he may want to move things along, as Ministers often do, but our job is not to move on until we are satisfied.
We must consider what the words suggested in the amendment add materially to the Bill. I confess that I am somewhat mystified. The original words are:
The report of the person who held the inquiry shall, unless the Minister who caused the inquiry to be held considers that it would be inappropriate to publish it, be published in a manner which that Minister considers appropriate.
I accept what the Minister said—there is a presumption of publication. In the new world of open government, that is as it should be. However, the Bill already states that if the Minister considers publication inappropriate, the report will not be published. According to the amendment, the report will be published unless there are exceptional circumstances. For the life of me, I can see no material difference.
Of course, I am not remotely querying the sagacity of the selection of the matter for debate—far from it—but there is an onus on the Minister, who is suggesting a different form of words, to explain to us more fully why he concluded that the original wording in his own Bill was not satisfactory for the purpose that he stated, and why the new words are a material improvement. That, after all, is why we are considering the matter.
I thought that the original words were perfectly fit for the purpose. Obviously, I do not want to digress or delay the House unnecessarily, but we could get into a debate about that. The Minister gave us one or two examples of possible exceptional circumstances. We do not need to get bogged down in that, but we may want to know to what extent the Minister thinks that the power, in the existing words or the Government amendment, is likely to be invoked.
The Minister wanted to reassure us that that would rarely happen but, as we all know, the good intentions set out at this stage in the proceedings to make us feel warm and comfortable about something often do not stand up in the cold, harsh light of the real world, when the matters on the statute book are tested in practice.
Amendment No. 31, which was tabled by the Liberal Democrats, rather puzzled me. I got the impression that the amendment was designed to restrict the powers in the Bill, and I was not sure why that was necessary. The present wording is fairly general—
considers it necessary or expedient to have for the purposes of its functions under this Part.
The important question is whether adding "of regulation and inspection" strengthens, clarifies or limits it.

Mr. Burstow: It does.

Mr. Forth: In typical Liberal Democrat fashion, the hon. Gentleman says, "it does" when I have asked three different questions. Perhaps he would like to pick one of the three and help me.

Dr. Brand: Wait and see.

Mr. Forth: The hon. Gentleman is reluctant to help, but his hon. Friend tells us to wait. I am really excited now. We have had a hidden Liberal promise of clarification to come. I shall contain myself for now, exercising patience in the expectation that the hon. Member for Isle of Wight (Dr. Brand) will regale us later with a much fuller explanation of what the amendment is all about. I shall restrict myself merely to posing my

questions now, but if the hon. Gentleman does not keep his promise, I shall find some way to punish him. He can only guess right now at what my means may be, but they may become obvious as the night wears on.
That brings us neatly and satisfactorily to amendment No. 96, which is much more interesting and with which my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) dealt very ably. More and more as we consider Bills, we debate the necessity and wisdom of giving powers of entry and investigation to authorities and bodies, and the extent to which we wish to make those powers general or to restrict them.
I can see what my hon. Friend's amendment is driving at: he wants to restrict to genuine local authority premises powers that could be extremely wide and intrusive, and he wants to ensure that private dwelling houses are not covered. I confess that I wonder whether that would inhibit the legitimate purposes of the Bill and the bureaucracy. I am caught in a dilemma on this point: I have explained my reservations about bureaucracies, regulatory powers and powers of entry, but I must, reluctantly, accept that once the House has accepted the general purpose of a Bill, we can only ask whether it will be effective.
There is a slight risk—I put it no higher—that amendment No. 96 could, in some circumstances, inhibit or restrict the proposed powers. I can imagine circumstances in which something happens in the private house of a foster parent about which we may have legitimate concern. Given the relationship between foster parents, local authorities and the proposed bureaucracy, we can query how far the Bill's powers should be restricted or left broad.

Mr. Ian Bruce: rose—

Mr. Hammond: rose—

Mr. Forth: My hon. Friend the Member for Runnymede and Weybridge can help me because he proposed the amendment.

Mr. Hammond: I recognise my right hon. Friend's concern, but there are two points at issue. First, powers exist, particularly under the Children Act 1989, to allow entry in order to protect a child at risk. Secondly, we must make sure that our sanctions and intrusions are proportional to what we seek to do. I believe that my amendment has the balance right.

Mr. Forth: I am grateful. If my hon. Friend cannot envisage circumstances in which his amendment would prevent the proper discharge of the duties in clause 44, I must be satisfied.

Mr. Hammond: I should make it clear that the Minister has already told the Standing Committee that in the Government's view, there is no power of entry to a private dwelling house under this part of the Bill. The amendment would simply make the Bill clear, which, in my submission, supported by my right hon. Friend's interpretation, it is not at present.

Mr. Forth: That is helpful. Of course my hon. Friend has just shown the disadvantage that those of us who did not serve on the Standing Committee have in such matters. I will not be tempted to dilate on Pepper v. Hart; he is not trying to do so. If the Minister has put that on the record in Committee, that may be good enough. Of course I accept what my hon. Friend says; he wants only to put such matters beyond doubt—even beyond the Minister's words, which are on record. The Minister has already said that that is an appropriate matter and I am grateful to my hon. Friend for that clarification.

Mr. Bruce: I, too, did not serve on the Standing Committee. Indeed, I had not read clause 44 until warming up for the debate, but I have read the Regulation of Investigatory Powers Bill, which will restrict law enforcement officers and all sorts of other people from entering a private dwelling or whatever. It strikes me that, without amendment, the Bill could directly contradict another Government measure that is being considered in the House of Lords. Will my right hon. Friend comment on that extraordinary situation?

Mr. Forth: My hon. Friend may think it extraordinary, but I am not sure that I do. He characteristically gives the Government the benefit of the doubt in assuming that they are consistent. I have never believed that and, in his perspicacious way, he shows that the Government are all over the place.

Mr. Bruce: That is putting it mildly.

Mr. Forth: Yes, it is. Perhaps my hon. Friend would like to develop that point in his own way; I do not want to encroach on his territory.
I shall move on swiftly to amendments Nos. 3, tabled by my hon. Friends, and 32, tabled by the Liberal Democrats, by which they seek to pre-empt or prescribe the way in which the commission will discharge its responsibilities. That is an important issue. We should carefully consider whether it is beneficial for the House to prescribe how the commission will work, even in the way in which my hon. Friends suggest.
Amendment No. 3 states:
The commission shall establish…an independent Healthcare Committee…a Nursing and Care Homes Committee…a Directorate of Independent Health Care…a Directorate of Nursing and Care Homes… The Secretary of State may by regulations define the respective responsibilities…
That seems to go a bit far, even for enthusiasts of bureaucracy. Either we have reasonable confidence about how the commission will discharge its duties, or we do not. Even at this late stage, my hon. Friends want to state in detail how the commission will be structured and how it will carry out its responsibilities. I make no apology for taking them to task, but they even want to state that there should be
an Independent Healthcare Committee chaired by a Commissioner who shall have specific responsibility for the Commission's functions in respect of independent hospitals…
I yield to none in my admiration of my hon. Friends' perspicacity and foresight, but for them to suggest that they can envisage, with such clarity, how the commission should function and discharge its duties seems to go a tad far, and I therefore remain to be convinced.

Mr. Simon Burns: I want to press my right hon. Friend on that matter. I fully appreciate the

point that he makes, but we shall have only one stab at the Bill. Can he foresee how the law could be changed if such a provision were not included and the experience of the system working in practice suggested that what my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) proposes in amendment No. 3 was needed?

Mr. Forth: In an attempt to justify the wording of amendment No. 3, my hon. Friend gives the game away completely. He has reminded the House, as I was about to, that it is difficult, though not impossible, to alter or remove a proposal once it has been included in a Bill. That is my worry.
By my reading, if we do not use either the wording suggested by my hon. Friends or that suggested by the Liberal Democrats, the commission will be free—within the broad terms of its remit and, if necessary, under guidance from the Secretary of State, which is also in the Bill as a longstop or failsafe—to structure itself as it sees fit and to set up such sub-committees as it sees fit. That will provide the flexibility to enable it better to react to changes in circumstances. As my hon. Friend the Member for West Chelmsford (Mr. Burns) points out, if a well-meaning form of words is included, it will be there for ever, or at least until a future Government get round to trying to change it. Were the Government to be re-elected, we know that their legislative programme would be so full that the chance of changing the wording would be zero.

Mrs. Jacqui Lait: I have huge sympathy with what my right hon. Friend says, but will he bear in mind that the Bill already provides for a children's rights director who, although not a commissioner, is specifically referred to? That is frightfully politically correct, and I accept his reaction to that, but does he accept that independent health care and social and nursing care, to which my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) refers in amendment No. 3, are the two areas in which the Government find the greatest anathema in respect of providing care across the spectrum? Therefore, specifying that a commissioner is responsible for those areas will make it palpably clear that the person appointed will be put under the spotlight to ensure that the commission's powers are exercised truly impartially.

Mr. Forth: I am grateful to my hon. Friend and neighbour, who has given as elegant an explanation of amendment No. 3 as one could expect. I can of course see the force of what she says, but again my reservation is that circumstances can change rapidly, as we know, and sometimes to our cost. My worry is that committing ourselves to such a degree of detail at this stage would also commit the commission and create the danger of rendering it relatively inflexible when flexibility is of the essence. I still have my reservations, in spite of the valiant effort to persuade me.

Mr. Bercow: Will my right hon. Friend give way?

Mr. Forth: Yes, I shall let my hon. Friend have a go.

Mr. Bercow: I understand my right hon. Friend's objection to, and general concern about, the excessive


rigidity or specificity, but is there not another concern, which I would usually expect him to express? Unless there is some codification in the Bill, the danger is that unamended Henry VIII clauses will allow a usurpation of a power, to which he would usually object.

Mr. Forth: Of course I accept what my hon. Friend says, but my assumption is that the Secretary of State will soon be a Conservative Secretary of State. Therefore, what my hon. Friends have in mind and what my hon. Friend the Member for Beckenham (Mrs. Lait) suggested a moment ago could be achieved elegantly and amply under the existing wording. I know that none of my hon. Friends assumes or even expects the Government to be re-elected, so there is no need to put a defensive and protective provision in the Bill and set it in concrete.
However, my hon. Friend the Member for Buckingham (Mr. Bercow) has made an important point, as usual, and, as always, we are in a dilemma as to whether we, as legislators, believe in a general power for a Secretary of State, with the flexibility that goes with it, or think it preferable to include ever more detail in legislation—perhaps to restrict the opportunities for a Secretary of State to intervene. There are more than sufficient powers for the Secretary of State in the Bill. Henry VIII is wandering through the Bill, and this attempt to pre-empt or restrict that probably will not succeed. I remain to be convinced by the amendments, although I will listen to the many different views that will be expressed over the next hour or two.
Amendment No. 82 may be the most interesting and worrying of the amendments and proposes something with which we have become familiar—the powers of delegation. It says:
An authority may make arrangements with persons under which they, or members of their staff, may perform functions of members of the staff and of the authority.
I will not repeat my earlier argument but I am not sure how this adds to the original wording.
Such provisions always lead to wider issues, as we have seen in other Bills. How far does the Minister believe the proposal will go? Could there be restrictions on the persons with whom arrangements are made and to whom delegation is given? Either we take a fairly restrictive view or there will be a flexible arrangement. The Minister must assure us that the exercise of powers under the amendment would be limited and restricted and that a guarantee or safety mechanism will be available so that there is no danger of delegation to persons who are not fully qualified.
If the authorities find themselves under pressure to fulfil their responsibilities, there may be a risk of delegating to the wrong people, and we will be right back at the difficulties with which the Bill is trying to deal. The present wording—even with the imprimatur of the Minister and the Secretary of State—worries me. I might have been reassured if it had said "appropriately qualified persons" or "persons with appropriate references". However, the current wording appears to leave the matter loose and over-flexible.

Mr. Hammond: Does my right hon. Friend conclude that those persons to whom the powers are delegated will have all the powers of entry that inspectors have under the Bill?

Mr. Forth: That must be a suspicion. Some wide powers may devolve, worryingly. to unspecified persons.

It is not good enough for the Minister to say that flexibility is needed and that provision must be made for other people to be brought in. In this of all matters—given all the sensitivities that surround it, and all the history behind it—if we are to legislate properly, and provide the reassurances and guarantees that are required, we must have a form of words that gives us more reassurance than we have now.

Mr. Bercow: As the devolution of responsibility may entail contracts with outsiders, can we at least be reassured by the Minister—in so far as he feels able to attend to the debate—that such arrangements will be undertaken only after a process of competitive tendering? Or will this take place simply on the basis of the old pals act?

Mr. Forth: I hope that others are listening, although the Minister patently is not. Perhaps he will be appropriately advised at the appropriate time, although it may take quite a bit longer than he thinks if he carries on in the same way. I may have to repeat everything when I think he is listening to me, and I doubt that he would want that.
My hon. Friend the Member for Buckingham has raised an interesting point. The mechanism whereby the delegation is to be achieved is unspecified. The wording gives no hint or clue about the connection between the delegating authority and those to whom the important powers may be delegated—including potentially, as my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) pointed out a moment ago, powers of entry, inspection or whatever.
We are completely in the dark about who the people concerned may be, what guarantees or reassurances we may have about them, their relationship—contractual or otherwise—with the authority, and the extent to which the authority may have sought appropriate reassurances in terms of qualifications or references. We know none of that, and the wording gives no clues. I fear that amendment No. 82 poses at least the danger—I put it no higher than that: not the likelihood, but the possibility—that a risk of some kind could emerge. That, as I understand it, is exactly what the whole Bill is intended to avoid.
The new clause and Government amendments illustrate all too well the dangers that we encounter when we embark on the route of bureaucracies, regulations, regulatory powers, regulatory mechanisms and the like. No matter how well justified such measures may appear on the face of it, we can readily see those dangers just from this first canter around the course. For we have not yet reached the meat of the Bill: although we are discussing important matters, there is much more to come. Already, in scratching the surface in a rather superficial way, we have dug up all sorts of difficulties. The Minister could not reassure us, and—if I may say so—even my hon. Friend the Member for Runnymede and Weybridge,


in his much clearer and more concise speech, was unable to answer all the questions that, in my modest and very brief way, I have tried to pose.

Mr. Bercow: Will my right hon. Friend give way?

Mr. Forth: I will give way once more, but I am trying to conclude my speech.

Mr. Bercow: I am exceptionally grateful to my right hon. Friend for his characteristic generosity. I am sorry to interrupt his flow, but I wonder whether he can answer a question. Speaking to amendment No. 32, the hon. Member for Sutton and Cheam (Mr. Burstow) argued that the regulations that he advocated should be subject to the negative or the affirmative procedure. The capacity to debate the regulations, however, is surely of the essence.

Mr. Forth: It is to my hon. Friend and me, but I do not recall the hon. Member for Sutton and Cheam (Mr. Burstow) saying as much. I do not think that the Liberal Democrats are all that bothered about parliamentary scrutiny, or about negative or affirmative resolutions. They are not here very often, and when they are they seem to be in the Government's pocket. My hon. Friend and I pay close attention to such matters, but I do not think that we can look to the Liberal Democrats to help us, now or in the future.
All in all, an awful lot more will have to be said about the new clause and some of the amendments before I am satisfied. Although the Minister did not listen to some of what I said—I cannot imagine why—I know that, having been properly advised, he will be able to give full and comprehensive answers to my points and those made by others. We shall have to make our judgment on the basis of those answers when—somewhat later, I suspect—we vote on the new clause and amendments. The position is certainly not self-evident to me.

Dr. Brand: This is the first time that I have had the privilege of following the right hon. Member for Bromley and Chislehurst (Mr. Forth) and it is a curious experience. At the outset of his contribution, he declared himself as a legislative nihilist—he does not believe in regulation and clearly feels that the safety of vulnerable people should be left either to the marketplace or to self-regulation. He then talked about having more powers for the Secretary of State without making them explicit in the Bill, and turned that argument round and said that the Bill was not explicit enough, so I find that confusing.
The right hon. Gentleman made a threat, which I did not find alarming; I was not surprised at his comment. It was not even an implied threat. It was that we might all be punished tonight by some means not yet declared if we did not toe the line. I am not aware that activities in the Chamber are designed to indulge either masochist or sadistic tendencies. I am sure that we will get many contributions from the right hon. Gentleman. If he would let me know how long he is going to take, we can rest while he makes them.
I address my main remarks to amendment No. 31, which deals with clause 31. There is a concern that we do not give the commission undue powers. Clause 31 says

that the registration authority can require—presumably, it is a statutory requirement—to have information made available if it is "necessary or expedient". I can see that it may be expedient for a registration authority to ask for all sorts of information, but I am also aware that red tape is a major imposition, especially for small businesses, and that information does not come free. It takes time and resources. Incidentally, it also takes time and resources to analyse it once it has been obtained. It is clear from the rest of the Bill and from some of the earlier comments that the commission will have a role over and beyond registration and inspection.
It is right that the commission should have statutory powers to require information to be made available where it is dealing with the safety of the public. Therefore, in relation to its registration and inspection function, it is totally appropriate that anyone running an establishment described under the Bill should be made to provide information when it is requested, but I have an anxiety that that statutory requirement might be extended, because it is convenient and expedient for the registration authority, to other areas such as the giving of strategic advice to the Minister on how many beds might be needed in 10 years, and what the industry's intentions are on retirement and non-retirement.
Those are important issues. Clearly, consultation with the industry is important, but it should be consultation on equal terms, rather than a requirement by law. It is a simple amendment. I hope that the Minister will take it on board. It in no way diminishes the powers of the registration authority in its primary function: the protection of the public.
I touch on the other amendments in the group, notably Nos. 3 and 32. My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) Sutton has squared the circle in relation to regulation and inspection of acute and chronic services in the private and public sectors. In my clinical practice, I sometimes find it difficult to decide in which of the four categories a particular patient is in the course of treatment or the course of a disease. The permutations are quite large. It would be helpful if we had a common regulation and inspection regime.
To have the Commission for Health Improvement as the specialist hospital arm, the specialist medical arm, of a national commission makes extraordinary sense. It would still allow the Government to have their own machinery to advise them, but it would also create a healthy, slightly arm's-length relationship, between the Secretary of State in his managerial function with regard to the national health service and the Secretary of State in his regulatory role through the Commission for Health Improvement. I urge the Government to look at that as a way of still accepting that the NHS is different from the private sector, but overcoming their dogmatic doubts about a common way of dealing with the problem.
As usual—it is the usual phrase that we used in Committee—I look forward to the Minister's response. I hope that he will give us some confidence on small matters, but that he will consider the real nub of the argument, which is the safety and quality of standards for all people needing medical, nursing or caring services, irrespective of who provides it and where it is provided.

Mrs. Lait: Before I contribute to the debate on the Bill for the first time, I should like to put on record the fact


that before I entered the House in 1992, the National Care Homes Association was a client of my lobbying business, but that subsequently, I have had no remunerative interest in the association at all. However, my husband is the leader of the Conservatives on East Sussex county council, and of course, all social service issues are a responsibility of county councils. For a brief period, he was chairman of the social services committee, and tried hard to persuade the county council to get rid of its substandard care homes. The Lib-Lab pact managed to defeat that, but the objective still remains.
By putting those two things on the record, I hope that I have not only clarified my position, but made it clear that I have some knowledge of many of the areas that we are talking about. Indeed, I have long advocated the establishment of some form of national standards and care structure for the social care and nursing care sectors. Therefore, in principle, I do not have a difficulty with the structure of the Bill as it has emerged from the various stages of its consideration.
It may cheer the heart of my right hon. Friend and neighbour the Member for Bromley and Chislehurst (Mr. Forth) that one of the most overbearing parts of the private sector care standards regime is being totally repealed by the Bill. The repeals list shows that the Registered Homes Act 1984 and the Registered Homes (Amendment) Act 1991 will both be repealed in total, so one form of bureaucracy—a very hard and overbearing bureaucracy—will disappear.
I hope that my right hon. Friend—I see him nodding—will appreciate that occasionally, legislation can lead to the death of bureaucracy, as well as—as is happening in this case—the creation of further bureaucracy. It is the concerns about the further bureaucracy that I shall take up, as will many of my right hon. and hon. Friends.
Government new clause 16 is about the advice to Ministers on fostering and adoption. I think that we have established the fact that the advice and how it is implemented will be covered by regulations, which will be taken under the negative resolution procedure. Most Conservative Members find that somewhat concerning, because that procedure makes debate so difficult. However, what concerns me even more is the lack of any assurance that before regulations are promulgated, those who will be affected by them will be consulted. That concern is reinforced by the fact that publication of the commission's advice will not be mandatory.
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It is therefore possible, even for one who is not a conspiracy theorist, to envisage a situation remarkably similar to one with which many care homes are already familiar—the sudden introduction of an entirely new fostering and adoption regulatory regime, without any notification to those affected by the new regime.

Mr. Bercow: I think that my hon. Friend is right to say that the Government have opted for the negative procedure. However, we have to know the reason for Ministers' knee-jerk reaction and preference. Is it because they do not think that we should be allowed to debate such regulations? Is it because they cannot trouble themselves to have such a debate? Or is it because we do not have sufficient time? The last explanation would be quite unsatisfactory to many hon. Members, who would

be more than happy to attend a morning sitting of the House to debate the regulations, based on the authoritative advice that has been tendered to Ministers.

Mrs. Lait: I entirely agree with my hon. Friend, who makes some sane and sensible points. I also think that use of the negative resolution procedure is always very sinister. I am simply seeking assurances from the Minister that there will be proper consultation on regulations, and that the commission's advice will be published.
The commission is a public body, funded by taxpayers. Therefore, it has a responsibility to taxpayers and the public to make public precisely what it is suggesting to Ministers. It is crucial that Ministers reassure us today that, one way or another, there will be proper scrutiny of proposals affecting fostering and adoption—both of which are so fraught with emotion and so important to people's futures. Very many bodies are involved in the subject, and they need to be consulted.
As all hon. Members know from their surgeries, rumour and innuendo get around, and out of small acorns grow very large oaks. Rumour and innuendo can threaten an entire system. Therefore, correct information has to be placed in the public domain at the right time.
Government amendment No. 53 deals with the publication of reports. Although I am not a lawyer, I absolutely accept the difficulty of the libel issue and of the possible consequences of prosecutions. It may come as no surprise to my hon. Friends to hear that I was the Parliamentary Private Secretary to the current Leader of the Opposition when he was Secretary of State for Wales, and the Welsh Office was debating whether he should establish the inquiry into the Welsh children's homes. We grappled at length with the issues of libel and prosecutions. However, my right hon. Friend had the guts and the courage to establish that inquiry, and to take on the chin the possibility of difficulties arising from subsequent legal action.
If my right hon. Friend had the courage to do that, I cannot see for one minute why the Government cannot give us assurances today, or even write something into the Bill. They could abandon their amendment, so that reports of concern to the public were published. As I said, if the relevant information is not made public, rumour and innuendo will spread and the situation will get completely out of hand. I would not like to see any Government on the back foot in addressing issues that are so important to so many people.
The Liberal Democrats' amendment No. 31 deals with the National Care Standards Commission. I have some difficulty with the idea of enabling the commission to trawl for information, in a fishing expedition. Such an ability was one of the reasons why the local government inspection system was regarded with fear and trepidation within the private care home sector. In that system—not in all cases, but in a sufficient number of cases to concern the industry—inspectors essentially had that power.
I hope that in considering the information that it wants and needs from people, the commission will take into account the long history of difficulties between inspectors and the private care sector. To give those inspectors their due, the badly run businesses have now gone out of business. The commission will therefore usually be dealing with well-run businesses. The businesses that have survived—it has been a tough world for them—have


done so because they are good businesses. Therefore, although there is no need to provide the power to undertake fishing expeditions, there is that history, and such a power is not beyond the bounds of possibility.
I share the concerns expressed by my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) about the potential impact of amendment No. 31. Of course we very much hope that the horrors that we are envisaging do not materialise.

Mr. Burstow: The import of the hon. Lady's argument seemed to be that she was broadly supporting amendment No. 31—which is about preventing the very fishing exercises that she has been concerned about. Can she say whether she supports the amendment?

Mrs. Lait: I apologise to the hon. Gentleman; he is absolutely right. I am more likely to be supporting him than the Government on this particular issue.
I share the concerns expressed in the official Opposition's amendment No. 96, not only because I am a great believer that an Englishman's home is his castle. I am surprised that I am the first hon. Member to use that cliché in this debate, because it is such an obvious one in discussing the amendment. Like many other hon. Members, I know people who have given a lot of their life, time, love, affection and emotion to fostering children. As I am sure all hon. Members will know, many of those children are very difficult and complex characters who have deep-seated needs that foster parents have to deal with.
Consequently, over the years, in any well-run fostering regime, a body of law has developed that allows access to a foster parent's private home, either by agreement or—when potential child abuse is involved—by instant access. I am sure that many hon. Members will have had constituency cases involving neighbourhood conflicts and difficulties in which, on the flimsiest pretext, although the children themselves have often been difficult, neighbours have taken a dislike to each other and called in social workers and police. In those circumstances, foster carers' homes have easily been accessed by those who wanted or needed access.
Therefore, on the basis of what we know happens in practice and what is often dealt with in statute, I do not know why the Government cannot reassure people by including in the Bill an exception ensuring that private homes are not covered by the Bill's provisions on rules of entry.
It may be that legislation cannot impose a negative, but I do not believe that the clever people who draft legislation cannot come up with a form of words to reassure people who foster difficult children that, although their homes will continue to be accessed by social workers and police, as is required by statute, the Bill will not impose further requirements so that any misuse of its provisions presents a further barrier to people volunteering to foster difficult children who need loving homes.
Hon. Members may have gathered that I support amendment No. 3 because I have concerns about the text of the Bill. When I first reached the conclusion that a national organisation would help the care home industry to provide better care, I was very clear in my own mind that the

National Care Standards Commission would need to appoint people who represented and had thorough knowledge of the industry. The proposal for separate commissioners for the independent health care sector and for nursing and social care, with separate directorates, would meet that requirement and would go slightly further than the Bill does in respect of the children's rights director.
Many of us who have some knowledge of the residential and nursing home sectors realise that it is not easy to consider them as indivisible. A nursing home provides nursing care. The demands and requirements on a nursing home are different from those on a residential home, which is a place where people live as independently as possible. They require totally different skills that require different training, although residential care homes for elderly people provide an element of nursing care. However, if a properly run rest home has people who need nursing care there is usually someone on the staff to provide that care and it is usually the sort of care that a district nurse can provide. If somebody is too ill for that, their medical condition will dictate where they are looked after—[Interruption.] I heard someone say, "nonsense" and I would be most interested in the reason for that remark.

Dr. Brand: Over the past 15 years there has been a dramatic shift in dependency from nursing homes to residential homes and it is not unusual to have people in residential homes who might previously have been in nursing homes, certainly towards the end of their lives. I would not want people to be forcibly moved from what has been their home when they become terminally ill.

Mrs. Lait: I am not entirely certain that the hon. Gentleman and I are a million miles apart on this. If someone were terminally ill and living in a residential home, as that would be regarded as their home, they would get the same care that would be provided in their own home.

Dr. Brand: Does the hon. Lady accept that a great many people who live in their own homes have a nursing dependency as great as people in nursing homes under hospital at home schemes and the like? The differentiation is not as clear as the hon. Lady implies.

Mrs. Lait: The hon. Gentleman and I could have a long dialogue on this, although you would probably call us to order if we did, Mr. Deputy Speaker. As I said, I do not think that the hon. Gentleman and I desperately disagree about this matter. However, the bulk of people in rest homes are not there—or should not be there—because of nursing requirements. That is part of the argument for national care standards and for removing the involvement of local social services in placement into rest homes. As I said earlier, I have long believed in that.
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The amendments seek to ensure that two sectors in which the private sector has taken a strong interest—well-run private hospitals and nursing and rest homes—should receive the consideration that they require from the commission.
I see that my right hon. Friend the Member for Bromley and Chislehurst has returned to the Chamber. Let me pick up his point about what should happen to the commission


when we win the next election. I suggest that it would be helpful to have people with the right skills on the commission, and a directorate with specialist skills in the independent health sector and nursing and social care so that those two sectors get the attention that they require to ensure that they provide the highest care standards of which we would all approve.
Another reason why I support the proposal for a social and nursing care commissioner was mentioned by my hon. Friend the Member for Runnymede and Weybridge in relation to inspectors. We probably expect that most local authority inspectors will move over to the commissions under the Transfer of Undertakings (Protection of Employment) Regulations 1981, if for no other reason. I sincerely seek assurances that the inspectors will receive the necessary training to act in an even-handed way. As I said earlier, a number of local authority rest homes are not up to the standards that are required in the private sector. Under the 1984 Act and subsequent legislation, inspectors have no statutory remit to close local authority homes. However, good inspectors in some local authorities—there are some—made sure that some of the local authority homes were aware of their responsibilities. However, we cannot—the private sector would find it difficult to live with this—send in inspectors who are still of the old school and are not prepared to be completely impartial.
Let me briefly draw a parallel with Ofsted, which was mentioned earlier. Ofsted hires teachers and trains them to be inspectors. Unless the system has changed recently, once inspectors are trained Ofsted does not have the ability to decide whether they are good enough to do the job. Once somebody has been trained they automatically become an Ofsted inspector even if they are not suited to the job. I would not like the same loophole to exist in respect of commission inspectors. Once somebody has been trained, a decision will have to be made as to whether that person meets the required standards. The mere fact that somebody has been trained does not mean that they have attained the necessary standards.

Mr. Bercow: I am sorry to interrupt my hon. Friend as she develops her argument, but is she referring to in-service training or to some other training?

Mrs. Lait: I made the analogy with Ofsted because everyone wishing to become a school inspector has to go through the training that Ofsted offers. However, all trainees become school inspectors after the training, regardless of the extent to which they fit Ofsted's requirements. I do not want the same system to be brought in for the commission.
Finally, I have gained a little understanding of how what I have learned to call "CHI" works. A team from the health service is put together and sent to inspect a hospital. It usually consists of a medical director, a nursing director and a chief executive or member of senior management. Those people may be crucial to another hospital, but they are taken away from running their own hospital for at least a week. Given the state of the NHS and the number of hospitals needing inspection, will not the removal of such personnel for inspection purposes place an intolerable burden on all hospitals?

Dr. Brand: Rubbish.

Mrs. Lait: The hon. Gentleman may say that that is rubbish, but perhaps he will tell me why. A hospital trust

could be in trouble if even the smallest crisis emerged while its medical director was away for a week on inspection duties. We all know how long patients have to wait in accident and emergency departments in most hospitals, and how litigious they are these days, with hospitals often being challenged and asked to pay compensation. Taking key managers away from an understaffed and hugely pressurised health service is not the best way to ensure that our health service improves.

Dr. Brand: I cannot follow the hon. Lady's argument. Is she really suggesting that inspections, by Ofsted, the Commission for Health Improvement or any other body, should be carried out by people who are not involved with the service that they are inspecting? I understand what she says about pressure being placed on services, but that can be solved by adjusting staffing levels. I assure her that the NHS carries out a great many inspections, and that about a tenth of consultants' time is spent on them. That is quite apart from their educational role.

Mrs. Lait: The hon. Gentleman is a GP and has a direct interest in how the NHS works. He probably knows how much inspection is carried out. I am merely pointing out, however, that the commission represents yet another layer of inspection. It will take people away from their real hospital work for a week, and then reports will have to be written. Taking out that level of management skill is not the best way in which to run the hospital service, let alone the NHS.
The hon. Member for Isle of Wight will agree that the NHS faces huge staffing difficulties. Imposing an extra burden is not the best way forward.

Mr. Burstow: Is the hon. Lady aware that a Liberal Democrat amendment tabled in the House of Lords secured cross-party support and gave effect to the principle that the commission would have a role in inspecting provision in the private and public sectors? The Government removed that amendment, against the opposition of my hon. Friend the Member for Isle of Wight (Dr. Brand) and the hon. Member for Runnymede and Weybridge (Mr. Hammond).

Mrs. Lait: The hon. Gentleman and I differ in our view of what the commission is doing at present.

Mr. Hammond: I thank my hon. Friend for allowing me to intervene and put in context what the hon. Member for Sutton and Cheam (Mr. Burstow) just said. I said earlier that my interpretation was that the Lords were trying to promote the desirability of a single regulatory system for both sectors. That was the essence of the debate in the other place.

Mrs. Lait: I would have no difficulty with a single regime for inspection. I am interested in the practical application of the commission's operation, given the difficulty in finding enough people of the right calibre to staff the NHS. We must not forget that the basic job of the service is to make people get well, and to prevent some from falling ill in the first place.
Mine is a practical objection rather than an objection in principle. No matter how much money the Government throw at the health service, it will not improve all that much in the near future. The Bill will not help those


hospitals that desperately need proper inspection—nor will it ensure that the independent health care sector does not provide a distraction.
I have spoken for longer than I planned. These diverse amendments set the tone for the matters in the Bill that need to be considered and that concern me deeply, and the debate on them is therefore worth while.

Mr. Ian Bruce: I did not intend to speak to these amendments, but my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) mentioned amendment No. 96, and thereby brought to my attention a specific problem.
Clauses 44(3)(b) and 45(3) set out the powers that allow the inspection of documents or other material, including computers. They contravene clauses 47 and 48 of the Regulation of Investigatory Powers Bill, which deals with all aspects of surveillance. Schedule 2 of that Bill sets out which people can issue a warrant allowing someone to inspect computers.
I believe that amendment No. 96, which would protect foster parents from such an inspection, should be more widely drawn. The Minister should know that any evidence obtained under this Bill without a warrant under the Regulation of Investigatory Powers Bill would be specifically excluded, by that Bill, from any legal proceedings. A proper investigation could be made that would then be ruled out of order because of the Regulation of Investigatory Powers Bill. I am no fan of that Bill, which I believe to be very flawed. It is extraordinary that the Department of Health and the Home Office should both introduce Bills in the same Session covering the investigation of what is on a computer in someone's premises whose provisions are in complete contravention of each other. My hon. Friend's amendment is very helpful in this respect.

Mrs. Lait: My hon. Friend might like to bear in mind the conflicts with the Data Protection Commissioner as to what information is protected, and the demands of the National Audit Office, particularly in the health sector.

Mr. Bruce: I am grateful to my hon. Friend. Right-minded people might think that the Regulation of Investigatory Powers Bill is a sensible measure that can be used to investigate child abuse, for example. Police officers who go into premises to investigate could think from having looked at the Care Standards Bill that they are authorised to get the records from the computer, print them out—perhaps even getting the key for encrypted data. They then think, "The case is all there in black and white." However, the defence lawyer, who is always paid more than the prosecuting lawyer, says, "The Regulation of Investigatory Powers Bill specifically excludes you from looking at these data, and if you have looked at them, a clause in the Bill says that you cannot use them in a court of law."
I hope that the Minister understands that I am not filibustering—this point hit me between the eyes instantly. I know that Department of Health Ministers have an awful lot to do—they cannot know what is going on in the Home Office. Frankly, somebody in the Government—

I thought that this was supposed to be joined-up Government, after all—should have understood the problem.
I hope that the Government will at least accept the amendment that would protect foster parents. I declare an interest, because my wife and I were short-term foster carers many years ago. I would not like to think that because we had volunteered to do that, our premises could be entered in the course of an investigation.
From looking at the Bill, it seems that someone's home is available to be entered. The Minister may say that it does not mean that. Even so, a police officer could enter a person's home and be told, "You can't come in," but if he showed them the Bill, the person would read it and say, "Obviously you do have the power." The individual is hardly likely to read Hansard and contact a lawyer for advice: he would instead assume that those powers were in the Bill.

Mr. Bercow: I shall certainly study Hansard tomorrow. Can my hon. Friend explain what wording in the Bill leads him to believe that there could be a laissez-faire approach to entry?

Mr. Bruce: My hon. Friend just needs to read clause 44, which says:
the registration authority may at any time require a local authority to provide it with any information relating to the discharge by the local authority of relevant functions which the registration authority considers it necessary or expedient to have for the purposes of its functions under this Part…
The clause continues:
a person authorised to do so by the registration authority—
although such a person is not authorised by the Regulation of Investigatory Powers Bill because the registration authority is not one of the named bodies—
may at any time enter and inspect premises which are used, or which he has reasonable cause to believe to be used, by a local authority in its discharge of relevant functions.
What happens is that local authorities approach foster carers to foster a child. The Government have quite rightly said that they will do their best to close down as many children's homes as possible and to put children into foster care or have them adopted, because that is best. If the only avenue that a local authority has when it comes to placing children is a private foster home or adoptive parents, those must be the premises referred to in the Bill. The Minister tries to reassure us that the words in the Bill, which are as plain as a pikestaff, do not mean that, but I am afraid that he is misdirecting both himself and us.

Mr. Bercow: I am grateful to my hon. Friend, who has duly alarmed me by pointing to the relevant provisions of clause 44. On the basis of his 13 years' experience in the House, will my hon. Friend confirm that it is commonplace, when discussing rights of entry for officers or other persons on public authority duty, for clauses to refer to "reasonable force"? However, as far as I am aware—my hon. Friend will disabuse me if I am mistaken—there is no reference in these provisions even to reasonable force, which opens up a worrying spectre of what might be entailed.

Mr. Bruce: Certainly, there are no such words in the Bill. Let us assume that a police officer is called because


an inspection authority officer is battering the door down. The person living there says that his premises are being invaded by the officer, who says that under the Bill he is authorised to enter and that, as he has been stopped, he is battering the door down. Nothing in the Bill says that there should be an individual at the premises—it is not about requiring people to allow entry to the premises, but about entry to the premises.

Mr. Hammond: It might help my hon. Friend to know that I explored this avenue with the Minister in Committee, and the hon. Gentleman confirmed that there will be no power to force an entry under these provisions.

Mr. Bruce: I am grateful to know that the Minister and my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) both know that. It is a pity that it is not made clear in the Bill.

Mr. Hutton: You caught me by surprise by calling me, Mr. Deputy Speaker. I thought that we were in for a couple more hours of debate on these amendments.
There is a small but substantial problem with amendment No. 31, in the name of the hon. Member for Sutton and Cheam (Mr. Burstow). We used to say in Committee—I am sure that the hon. Gentleman will not mind if I say it again today—that his amendments were largely unnecessary or technically deficient. Sadly, amendment No. 31 is both unnecessary and technically deficient, which is a first for his party on the Bill.
I should like to reassure the House that the registration authority will require individuals to provide only information that is needed for its regulatory work. Clause 31(1) states that it may require only information that it considers
necessary or expedient to have for the purposes of its functions under this Part.
Part II is concerned only with the commission's regulatory functions. It will therefore not be able to ask for anything that is not necessary for fulfilling those functions under this part of the Bill. That is the purpose of the hon. Gentleman's amendment, and I can assure him that that is already how the Bill is constructed.
Obviously, the commission will sometimes need to require a wide range of information from persons carrying on or managing an establishment or agency. I think that all right hon. and hon. Members will understand the common sense of that. The information will vary, according to the stage at which the service is being scrutinised. Inspectors will not have the powers to go on general fishing expeditions, however, if that is what the hon. Gentleman is concerned about. Nor will they have the power to require providers to give information that may be of general interest for statistical purposes, for instance. They might be able to request such information, and providers will, I hope, be happy to accommodate those requests, in the knowledge that national information of this kind can be useful to all concerned. However, such requests will not come with the force of clause 31.

Mr. Bercow: I am extremely grateful to the Minister for giving way on that point. He says that the commission will not go on general fishing expeditions, and I accept his word. However, can I take it from what he has said

that somebody seeking entry to conduct an inspection would subsequently, if there were a dispute, be obliged to prove that he or she had grounds for belief at the time?

Mr. Hutton: That must be the case. The powers under the Bill can be exercised only if the conditions of the Bill have been complied with. If there is any argument about that, the appropriate place to hold it might well be the court; it is precisely the type of issue that could be tested by lawyers before a judge. We do not propose any provision that would give the NCSC unique powers to act above and beyond the law—of course not. The hon. Gentleman is correct; no such situation could possibly arise.
Amendment No. 96, tabled by the hon. Member for Runnymede and Weybridge (Mr. Hammond), concerns the commission's powers to inspect premises under part III. In Committee, the hon. Gentleman rightly pointed out that that power to inspect applies to premises used by a local authority in the discharge of its functions. He asked me to look into the matter. Having taken further advice, I am satisfied that the power does not apply to individual foster homes, and we certainly have no intention that it should be used in that way. I agree that it would not be appropriate for the commission to exercise powers of entry to foster carers' homes in the same way that such powers would relate to local authority premises.
The hon. Gentleman's interpretation of the wording is that it would include powers to inspect individual foster homes, but I can assure him that that is not our reading of the provision. The private homes of foster carers are not under the control of local authorities, so it would not be sensible to treat them as though they were premises used by local authorities. We cannot consider that the amendment is either justified or necessary.
As I said in Committee, we expect that, in inspecting fostering services, the commission inspectors will need to speak to foster carers, and to satisfy themselves that the standards required of fostering services are being properly met through the foster carers approved by the authority. We all want assurance about that. That will mean that, sometimes, commission inspectors will need to visit foster carers in their homes, but the commission will not need general powers of entry to a foster home.
As I explained in Committee, we intend to tackle the matter by setting out a requirement—perhaps through the foster placement regulations under the Children Acts—for approved foster carers to co-operate with the commission inspectors when they are carrying out their functions. That will be reinforced by individual foster placement agreements that will set out what might be required for co-operation with the work of the commission. That approach will not give the NCSC a general power to enter foster homes, backed up by an offence of obstructing inspectors. That would be too heavy handed.

Mrs. Lait: By giving those powers to the commission inspectors, will the Minister do away with other regulations that give other people power of entry to a foster home?

Mr. Hutton: I assure the hon. Lady that we are not doing that. The Bill makes clear which provisions will and will not be amended. For example, we are not changing the powers of local authority officers in relation to their child protection functions; nor are we changing the powers of a police constable in the exercise of such functions. As the hon. Lady herself pointed out, it is important to retain measures to ensure that children placed in foster homes by local authorities are properly protected should there be any risk to their health or well-being.

Mrs. Lait: I am grateful to the hon. Gentleman for giving way again. Will he make it absolutely clear that the measure would give further rights to strangers to inspect a foster home and that foster carers would have to face additional bureaucracy?

Mr. Hutton: With great respect to the hon. Lady, I think that she has completely misunderstood the point. I have made it quite clear that NCSC inspectors would not have a power of entry to private foster homes. I tried to make that clear. Under the Bill, there will be no general power given to NCSC inspectors to enter private foster homes.
It is not the foster carer who will be regulated by the National Care Standards Commission, but the local authority or independent fostering agency. That is where the powers of the commission will rightly be directed.

Mr. Ian Bruce: By now, the Minister's officials will have had a chance to examine the Regulation of Investigatory Powers Bill. That measure makes clear the circumstances in which people can obtain information—especially from computers and other forms of investigation and surveillance. The Care Standards Bill is clearly in contravention of that measure. Will he address that point?

Mr. Hutton: I am pretty sure that it is not in contravention. I may have to qualify my comment later in our proceedings, but I think that the reason that this Bill does not contravene the provisions of the RIP Bill can be seen in clause 44, in which the hon. Gentleman was extremely interested. Clause 44 gives the NCSC the power to require the local authority to provide information. That does not involve the issues raised by the hon. Gentleman in relation to the RIP Bill. We are not inspecting computers. The clause requires the regulated provider—in this case, the local authority—in relation to part III, to require information to be produced to the local authority under the powers of the Bill.
If the hon. Gentleman will be patient, I think that the best way to deal with that point would be for me to give him a fuller explanation at a later stage of our proceedings.

Mr. Bruce: The hon. Gentleman contradicts his own Bill. Clause 44(3)(b) states that the powers include
in relation to records which are kept by means of a computer, power to require the records to be produced in a form in which they are legible and can be taken away.
That is exactly what is dealt with in the RIP Bill. The requirements for obtaining such information are set out in that measure and they are not complied with in the Care Standards Bill.

Mr. Hutton: With respect to the hon. Gentleman, I am quite sure that he is wrong. Later in our proceedings, I will find some way to satisfy him on that point.
Amendments Nos. 3 and 32 are similar in that they require the commission to establish statutory committees to deal with specific aspects of its responsibilities. Amendment No. 32 was tabled by the hon. Member for Sutton and Cheam. I share the hon. Gentleman's wish to ensure that private and voluntary health care is regulated effectively by the NCSC.
The Government's commitment to do so has, in our view, been amply demonstrated by the requirement that we introduced on Report in another place a power for the commission to appoint a director of private and voluntary health care, and to fund and head a health care division in the commission, whose functions will be prescribed in regulations. The independent health care sector has broadly welcomed those measures.
Measures that we have introduced provide the necessary assurance as to the importance that the commission will attach to its responsibilities for regulating independent health care. The hon. Gentleman's amendment would require the commission to have, in addition, a separate and statutory health care committee. That is where our views differ. The hon. Gentleman's approach, which is mirrored by that of the hon. Member for Runnymede and Weybridge, is over-bureaucratic. The benefits of his proposed solution are not clear. It would duplicate the work of the private health care division.
The amendment raises questions about the relationship between the Commission for Health Improvement and the NCSC in its role of regulating private health care. That is one of the issues that we have returned to throughout the passage of the Bill in both Houses. I accept that the relationship is important. The two bodies will between them have responsibility for standards throughout all the health care services provided in this country. They will have important common interests and shared experience.
We have repeatedly spelt out the arguments—although perhaps not to the satisfaction of the hon. Member for Sutton and Cheam—and have pointed out that the role of CHIMP in the NHS is not the same as that of a statutory regulator in the private and voluntary health care sector. CHIMP has been designed to work within the context of a publicly managed national health service, which is ultimately accountable to the House through the actions of my right hon. Friend the Secretary of State. CHIMP fits into a range of levers, incentives and controls—all under the overall management of my right hon. Friend.
Independent hospitals and clinics, on the other hand, are private businesses; they do not operate in a publicly managed system and are not under the control of the Government. If an NHS organisation is failing, it is the Government's job to do something about it. That is a responsibility and a burden that we take seriously. If necessary, the Secretary of State can intervene directly in the management of the NHS body, including, at the extreme, removing an entire trust board.
Amendment No. 32 would introduce a rather clumsy mechanism to try to involve CHIMP in the management of the NCSC. I do not think that it would be practical. It would establish a wholly superfluous layer of administration that would not be able to do anything that


could not already be accomplished by the National Care Standards Commission under the proposals that we have made. I ask the House to reject it.
Amendment No. 3, which was tabled by the hon. Member for Runnymede and Weybridge, proposes a statutory committee to deal with independent health care, and I do not think that I need to repeat my comments on that subject. It also proposes a further statutory committee within the commission to deal with nursing and care homes, plus a statutory director of nursing and care homes and a separate division for dealing with those services.
On a technical level, the amendment obviously leaves itself open to criticism. For instance, are care homes really to be dealt with totally separately from domiciliary care agencies? We all recognise that people being cared for today in residential settings may in future be equally well cared for in their own homes, but the amendment would run the risk of creating a new Berlin wall between those services in the way they are dealt with in the commission.
Although I cannot accept the hon. Gentleman's amendment, it may help if I say a little about how external interests, including regulated providers, will be able to work with the commission to feed in their views and to engage generally in dialogue with the commission. The hon. Member for Beckenham (Mrs. Lait) raised that concern.

Mr. Bercow: Given that we are waiting with bated breath and beads of sweat upon our brows, will the Minister please share with us the contents of the yellow piece of paper that the Secretary of State for Health has just passed to him?

Mr. Hutton: I do not think that the hon. Gentleman would like that; the piece of paper might be about him. He might not like what he has invited me to say. Therefore, I will not read it out. However, as I said earlier, I shall come to the points that the hon. Member for South Dorset (Mr. Bruce) raised when we come to the appropriate point in the Bill.
The commission, as a regulator, will obviously from time to time find itself in dispute with providers. From her experience, the hon. Member for Beckenham will be aware of such cases. However the commission's purposes will not be best served if it does not also engage in constructive and open discussion with service providers so as to allow feedback and proper suggestions from them and to work together to encourage improvement.
We certainly intend that there should be mechanisms in place to ensure that such discussion is an on-going feature of the commission's work. We expect arrangements to be in place at a local level to allow for such partnership working and for arrangements to be put in place at a national level for a dialogue to be established between the new National Care Standards Commission and care home providers' organisations and interests. I said in Committee that the relationship between the commission and care home providers will be central to making the arrangements work in practice and I want that relationship to be characterised by professional respect and a clear mutual understanding of each's responsibilities and respective roles. I am sure that the commission will want, once it is established, to develop that relationship with care home providers from all sectors—public, private and voluntary. That will be critical to ensuring that the arrangements work in future.
I hope that the hon. Members for Beckenham and for Runnymede and Weybridge are reassured that the commission will be open for business with regulated providers and others who have a stake in the work that it will do. If the hon. Gentleman's amendment is designed to ensure that care providers have a point of contact with the commission—that was partly his point—I think that we can make sure that that is available without having to set out the rigid structures that he suggested.
If, on the other hand, the hon. Gentleman really thinks that Parliament should be setting down in primary legislation exactly how the management structures of the Commission will be arranged, I will probably have to disappoint him, because I cannot agree that that is a sensible thing for the House to do. If he decides to press his amendment, I shall urge my hon. Friends to vote against.
My hon. Friend the Member for Chatham and Aylesford (Mr. Shaw) raised a point that is of concern to him and to my hon. Friend the Member for Lancaster and Wyre (Mr. Dawson). My hon. Friend the Member for Chatham and Aylesford referred to the efficiency and efficacy of the arrangements that supervise private foster care arrangements. I remind him of what I said in Committee. We share with him a concern for the proper administration of the existing regulations. We took the view, and we have stuck to it, that the regulatory framework is robust enough to deal with issues of abuse and concern about the welfare of children who have been privately fostered.
My hon. Friend asked me specifically whether I would be prepared to revisit the regulations about private care arrangements, and I say to him that I am prepared to re-examine them to satisfy myself once again that they are in the right shape to meet the concerns that he raised. I go further than that: if he and my hon. Friend the Member for Lancaster and Wyre wish to talk to me about how, in particular, they want the regulations to be improved, I am happy to have that conversation.
To some extent, the amendments tabled by the hon. Members for Sutton and Cheam and for Runnymede and Weybridge are a rehash of previous arguments. We have been through the arguments about the right relationship between CHIMP and the National Care Standards Commission extensively in this House, the Committee and in another place. I think that the hon. Member for Runnymede and Weybridge welcomed clause 9—the hon. Member for Sutton and Cheam certainly did—and it will allow the two important new bodies to work closely and effectively together. We should get on with the job, get the organisations up and running and, in doing that, better serve the public interest.

Question put and agreed to.

Clause read a Second time, and added to the Bill.

New Clause 4

STATEMENT OF NATIONAL MINIMUM STANDARDS

'.—(1) It shall be the duty of the Secretary of State to publish a statement of national minimum standards in respect of establishments or agencies required to be registered under this Part and to amend such statements from time to time as he deems appropriate.

(2) The Secretary of State may publish different statements under subsection (1) in respect of different descriptions of establishments or agencies.

(3) Before publishing a statement or amendments to a statement, the Secretary of State shall comply with the requirements of subsections (4) and (5) below.

(4) The Secretary of State shall—

(a) consult such persons as he considers appropriate and, in determining who to consult, he shall take advice from the Commission; and
(b) request the Commission to give him advice as to the likely impact of the proposed statement or the proposed amendment on—

(i) the aggregate supply of the service provided by establishments or agencies of the type concerned in England and Wales; and
(ii) the cost of supplying such services in accordance with the statement of minimum standards;



and shall then publish a draft of a statement or of amendments to a statement.

(5) The Secretary of State shall lay before both Houses of Parliament a draft of any proposed statement of national minimum standards or amendments to a statement together with copies of representations received in respect of the consultation under subsection (4)(a) and the advice received from the Commission under subsection (4)(b).

(6) No statement of national minimum standards shall have effect unless a draft of it has been laid before each House of Parliament in accordance with subsection (5) and has been approved by resolution of each House of Parliament.

(7) Where a statement of national minimum standards applies to an establishment or agency, no person may be registered in respect of that establishment or agency unless the applicable national minimum standard is complied with.'.—[Mr. Hammond.]

Brought up, and read the First time.

Mr. Hammond: I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker: With this it will be convenient to discuss the following: Amendment No. 38, in clause 22, page 13, leave out lines 14 and 15.
Amendment No. 39, in page 14, line 35, at end insert—
'(m) make provision in the case of an establishment providing cosmetic surgery as to—

(i) the nature of statements that may be made with regard to the services provided; and
(ii) the titles that may be used to describe persons carrying on, managing or employed at such an establishment'.


Government amendment No. 61.
Amendment No. 2, in clause 23, page 15, line 3, leave out Clause 23.

Mr. Hammond: New clause 4 and amendment No. 2, which is a paving amendment for it, would remove clause 23 from the Bill and substitute it with new clause 4. The new clause would do broadly the same things as clause 23, but with some important differences.
For the benefit of hon. Members who did not serve on the Standing Committee, I shall briefly explain what clause 23 does. It gives the Minister the power to
prepare and publish statements of national minimum standards applicable to establishments or agencies
and to keep the statements of standards under review. The statements will not be subject to any parliamentary scrutiny; they will be prepared by the Minister and published after the consultation that he considers appropriate.
Once the standards are published, they will "be taken into account"—that is a rather indefinite phrase—in making certain decisions and in any proceedings taken under the Bill. It also seems likely that the statements will be referred to in regulations made under other parts of the Bill. Therefore, the regulations that refer to the standards or incorporate them may be subject to scrutiny in the House, but the statements themselves will not be.
Of course, the Minister will consult with whoever he considers to be appropriate before he publishes the statement of minimum standards. However, I remind the House that people's businesses and livelihoods may be at stake and they may be driven out of business if they do not comply with the statement that the Minister has issued. For it to become effective, all he has to do is publish it; there will be no parliamentary scrutiny whatever.
New clause 4 and the paving amendment seek to do two things. First, the new clause would change the process of bringing into force a statement of minimum standards. It would place a clear obligation on the Secretary of State to prepare statements of minimum standards; he would not merely be allowed to publish them. The statements are a vital part of the structure that the Government are creating and the Secretary of State should have a clear obligation to prepare them.
Secondly, new clause 4 lays down a procedure for consultation outside Parliament and for a process of interaction with the commission, along the lines suggested by my right hon. Friend the Member for Bromley and Chislehurst (Mr. Forth) in the previous debate. That process would require the Secretary of State to require from the commission an analysis of the likely effect of the statements of minimum standards so that he can make a proper appraisal of their probable impact on the supply of services and the cost of providing them. Finally, it provides for proper parliamentary scrutiny of the draft statement of minimum standards before it comes into force.

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Mr. Burns: Will my hon. Friend clarify proposed subsection (4)(b)(ii), which is a crucial part of the new clause and refers to
the cost of supplying such services…?
Does that mean the cost of supplying the service to the business providing it or does it mean the cost of supplying the service to the individual who is benefiting from it? Or does it mean both?

Mr. Hammond: The two are obviously related, but the provision is intended to relate to the cost to the business supplying the service. Proposed subsection (4)(b) seeks to ensure that, when formulating a draft statement of minimum standards which is to be laid before Parliament, the Secretary of State has advice from the commission about the likely effect of such a statement on the aggregate supply of services in England and Wales and the likely cost of supplying them.
My hon. Friend spoke about the connection between the cost to the business of supplying a service and the cost to the person enjoying it. Of course, he could go further and discuss the cost to the public purse because, in the majority of cases, the service will ultimately be paid for from the public purse. There is, therefore, a direct


read-across from implications for costs on the businesses providing such services to implications for the public purse.

Mr. Bercow: Did I understand my hon. Friend correctly when he suggested that, in the absence of new clause 4, regulations will become effective on publication? Is my hon. Friend telling the House that, under the Bill, there is no required minimum period of consultation for draft regulations, and no required gap between the consultative process and the required date of implementation?

Mr. Hammond: As I understand it, the Secretary of State will consult such persons as he considers appropriate before publishing statements. However, those statements will become effective on publication. I am sure that the Minister will correct me if I have misunderstood that aspect of the working of clause 23.
May I go back to the point I was making about what the new clause seeks to do? First, it deals with the process of bringing such a statement into force and, secondly, it makes it clear in proposed subsection (7) that someone who does not comply with the statement of national minimum standards will not be registered. Clause 23 states:
The standards shall be taken into account
in making decisions, in any proceedings for making orders and
in any proceedings for an offence under regulations.
That seems to be rather vague for a matter as important as national minimum standards. If a national minimum standard is to mean anything, it should mean that someone who does not comply with it cannot come to the table. New clause 4 would therefore provide that someone who does not comply with the standard cannot be registered.
Of course, we accept that many standards are going to be made—indeed, some have already been made in draft. The Under-Secretary of State for Education and Employment, the hon. Member for Barking (Ms Hodge), has already circulated draft minimum standards on child minding. It would, therefore, be wrong to lead the House into thinking that statements of minimum standards published under clause 23 or, indeed, our new clause would relate only to care homes. However, everyone present will understand why I will focus on the statements of minimum standards for care homes, as there cannot be a Member who has not received correspondence from owners, operators and residents of care homes in their constituencies expressing concern about the potential impact of the national standards that the Government have circulated for consultation in the draft consultation document "Fit for the Future?".
We accept the need for minimum standards, which are a central feature of the Bill and the structure that the Government are putting in place. However, standards must not simply be aspirations: they must be deliverable, and the question of cost must be addressed. We have repeatedly asked the Government whether they accept that higher quality equals high cost and that that cost must be paid for. Do they recognise that the great majority of those in nursing and care homes are paid for by the state and the public purse? Therefore, as I have asked the Minister many times, does the state accept the implications for public spending and is it ready to meet them?
Throughout the industry, the concern is not that the Government want to raise standards—indeed, people would be delighted to operate to higher standards. The industry is concerned that the Government want to raise standards without paying the costs incurred, which will have a disastrous consequence. In the vast majority of cases, local authorities are the purchasers of this type of care. If they are not funded to meet the higher costs that these aspirations will impose, higher quality for the lucky ones will, inevitably, mean that no funding is available for others. Regrettably, the Government have consistently refused to address that point, and have not told the House or the Standing Committee whether they accept that there will be substantial costs and whether they are prepared to meet them in the case of those whose funding is met from the public purse. If the Government can reassure providers about that, many concerns will, at least, be diminished and, in some cases, will melt away completely.
We cannot look at the matter in a vacuum. The new higher standards in "Fit for the Future?" are being introduced against a background of tight finances for providers in the care home and nursing home market. They are dealing with the consequences of the national minimum wage—which has an impact in some areas, but not in others—the working time directive and other elements of the Government's social and employment legislation that have involved significant costs. They work in an environment in which, to a great extent, they face cost inflation of the type faced by the NHS, which is significantly higher than general inflation in the economy. In particular, wage and pay increases for NHS personnel, however welcome, have an inevitable consequence for competing employers in the private sector who provide services to publicly funded residents in nursing and care homes.
For many years, in many, if not most, parts of the country, providers of such care have faced below-inflation fee increases from local authorities that, with the best will in the world, cannot be more generous because their finances are too squeezed.

Mr. Burns: Has my hon. Friend considered the possible financial implications for local authority providers of residential care? There is much evidence that local authorities that still have residential homes do not receive in their Government grant the financial resources that will be necessary to upgrade the quality and structure of their premises to meet any minimum standards that the Secretary of State may set under the Bill.

Mr. Hammond: My hon. Friend is absolutely right to point out the difficulty in which local authorities find themselves. Local authority accommodation is some of the least compliant of any accommodation, and the Government's recognition of that is the main factor behind their intention to bring it into the regulated system. They want to create a level playing field and to ensure that the quality of that accommodation is improved. I say to my hon. Friend, however, that local authorities' ability to improve their accommodation, particularly through capital works, will depend ultimately on the Government making funding available or authorising local authorities to finance the necessary works in unconventional ways.
Many private care home operators, particularly the smaller players in the market, do not have the luxury of being able to anticipate capital grants from central


Government. As I shall show in a moment, they have found that the capital markets are closed to them because of the uncertainty created about the potential standards for nursing and care homes.

Mr. Ian Bruce: I do not know whether, in Committee, my hon. Friend received any assurances from the Minister that the Government would ensure that those who provide standards higher than the minimum—which, in looking after people, would be a natural way to get business—would not be financially penalised. It should not be possible for someone to say to them, "Although you are giving value for money in your provision, the minimum standards mean that you can provide the services for less," because that would force providers down to the minimum standard.

Mr. Hammond: My hon. Friend has made an important point. One introduces minimum standards with the best of intentions, but if the contracting price is set at the minimum standard level, one compels anyone who wants to participate in the market to reduce their standards to the minimum. As I said in Committee, I fear that that is inevitable unless the Government introduce a method to incentivise the provision of care over and above the minimum standards. I shall not digress further because that is another debate.
New clause 4 would require the Secretary of State not only to undertake the usual consultations, but to use his powers to require the commission to evaluate the likely impact on aggregate supply and cost. That is to ensure that decisions are properly informed and that the full impact of proposed national minimum standards is properly taken into account. The new clause provides for that information to be made available to Parliament. That would mean that a quasi-independent body would be required to review the cost and supply implications of any proposed standards or changes to standards. It would not be right to characterise the commission as a fully independent body because it is required to act on directions in writing from the Secretary of State. The new clause would therefore introduce objectivity into the debate about new or changed standards.
7.15 pm
I shall contrast that with what the Government have achieved with their draft standards for residential care homes. As many hon. Members will know, the Government commissioned a report, which they have put out for consultation. I believe that it contains some 280 recommendations, some of which are not controversial and will not have significant cost implications. Others, however, are highly controversial, and many of my hon. Friends will know from their postbags that the standards relating to staffing ratios and room sizes, in particular, have alarmed providers.
There is no doubt that the standards set in the draft document—10 sq m for rooms in existing accommodation and rooms of 12 sq m for wheelchair users and in newly built accommodation—would drive some providers out of business. I refer to particular individual providers whose accommodation is of a certain type and, perhaps, incapable of being easily converted. Other standards

would have a more general impact across all providers in the sector; for example, recommendations for staffing ratios would have the straightforward effect of increasing costs for providers of all sizes.

Mr. Bercow: My hon. Friend's grasp of the detail is positively Powellite, and I want to probe him on subsections (5) and (6) of the new clause, which properly require that a draft of the proposed national minimum standards should be subject to approval through a resolution of each House of Parliament. My hon. Friend will understand that I am troubled because it is not entirely clear from either subsection that the resolution of approval will require a debate.

Mr. Hammond: My hon. Friend raises an important point. Subsection (6) says that the national minimum standards will not have effect until they are approved by a resolution of each House of Parliament. I understand that that is what we know as the affirmative procedure.

Mrs. Lait: On a point of information, my hon. Friend has mentioned smaller homes, but what regime will cover three-bed homes?

Mr. Hammond: All homes will come under a standard regime. As my hon. Friend implies, some of the proposals in the draft minimum standards document will be more onerous for small providers than for large providers. If, for example, there were a requirement to have a member of staff in a management position who was supernumerary to the established staffing ratio, that would clearly be a more damaging blow to a very small home than to a large home provided by a large corporate provider.
I shall give the House some measure of the impact that "Fit for the Future?" would have on provision in this country if it were implemented in full. I do not want to mislead the House: the Minister has made it clear that the document will not be implemented in full. On this issue, he can be characterised as a man on a bicycle pedalling very fast backwards, but unfortunately we do not know where he will have got to when he stops pedalling, so uncertainty still hangs over the marketplace.
Let me illustrate the scale of the problem. The Department of Health has estimated that 20 to 23 per cent. of independent sector residential homes, 12 per cent. of independent sector nursing homes and 55 per cent. of local authority residential homes would not meet the draft space and amenity standards; and that 53 per cent. or more of nursing homes would not meet the draft staffing standards. Even those alarming figures ignore the impact of economics, considering only the possibility of meeting the standards by reducing the number of places and, thus, income; in the real world, in many cases, reducing the number of places would drive the home out of business.
Regional and local variations are even more striking. In the Southampton area, more than 50 per cent. of capacity in the residential market will be non-compliant. In Hampshire, a survey has shown that, overall, 71 per cent. of nursing homes and 68 per cent. of registered care homes would be non-viable. The position is worse in Portsmouth, where 88 per cent. of registered care homes and 65 per cent. of nursing homes claim that they would be non-viable if the draft standards were imposed in full. In the constituency of the other Minister of State,


Department of Health, the hon. Member for Southampton, lichen (Mr. Denham), 82 per cent. of registered care homes and 85 per cent. of nursing homes would be non-viable. In Blackpool, a staggering 91 per cent. of care home provision would be non-compliant with the 10 sq m standard; and I am told that in Blackburn that figure is an astonishing 100 per cent. of provision.
The problem is serious and, unsurprisingly in view of the figures I have just read out, it has provoked—in a masterly understatement—a reaction in the market; actually, it has produced something nearer to panic. Lenders have withdrawn; many potential sellers of homes have found that they are unable to sell their property because the buyer cannot know whether it will be compliant with a standard as yet undetermined and unpublished; potential new entrants are being denied access to capital, because no one knows what the final standards will be; and the presence of distressed sellers unable to sell causes a downward spiral in values. The overall result is chaos and blight in the market.

Mr. Ian Bruce: New premises have to be larger to comply with the regulations, and someone selling a business will, in effect, lose his registration. Will a new business taking over the same premises with a new registration come under the regulations for new premises, or those for old premises?

Mr. Hammond: That brings me back to my description of the Minister as a cyclist furiously peddling backwards. The concern that my hon. Friend expresses was circulating widely in the marketplace until very recently. However, the Minister recently wrote to me specifically confirming that transfer of ownership will not constitute a trigger event that would cause a change of status requiring the larger room size standard.
To be fair, as I always try to be, the Minister has been doing his best to stem the tide of speculation that has been rising for the past year and causing considerable harm; he has been engaged in a damage-limitation exercise, drip feeding pieces of information as and when possible, in an attempt to dampen expectations of the final standards. However, the fact remains that he has been unable to make a definitive announcement of either the standards in the key areas that are the source of disruption in the marketplace, or, most critical of all, the time scale for compliance. To be frank, those are the only two pieces of information that will calm the market.
The story becomes worse, degenerating into Whitehall farce. At the beginning of the Standing Committee's consideration of the Bill, the Minister said that he should be able to
share with the Committee some of the detailed thinking—[Official Report, Standing Committee G, 6 June 2000; c. 29.]
on the standards by the time that Committee reached consideration of the relevant part of the Bill. At that time, it was common knowledge that negotiations were being held with providers of residential and nursing accommodation about the detail of the most contentious remaining issue: room size. As the Committee made progress, hon. Members were delighted to be invited to the Department of Health, there to partake of the largesse of Her Majesty's Government and to look at a little display showing what the different room size options meant in practice: helpful plastic cut-outs had been laid on the floor and some plans prepared by NHS Estates were hung on the wall.
That lunch set alarm bells ringing in the minds of some, because the plans clearly showed that the area of the room occupied by the sweep of the door as it opens—that arc—was to be excluded from the calculation of usable space, as were any en-suite bathroom facilities. I questioned the Minister in the Committee that same afternoon; he replied that it had always been intended that only usable space would be measured. I and people outside took that as confirmation that the area swept by the opening door and the en-suite bathroom would be excluded.
I am happy to say that the Minister has since made matters clear in correspondence, which I have faxed on to everyone I thought might be interested. He has stated that it is not now the Government's intention to exclude the door-opening area and en-suite bathroom facilities when calculating usable space. I am delighted to hear that; otherwise, we would have faced the absurdity of care home owners who two years ago had spent large sums installing en-suite bathroom facilities—as one owner that I met had—being forced to take them out to comply with the minimum standard. That would have been bureaucracy gone mad, especially as surveys consistently show that the facility most valued by residents in care homes is an en-suite bathroom.

Mr. Bercow: I am somewhat reassured by the letter my hon. Friend has apparently received from the Minister, but does he not agree that it is only right that such an assurance should have been forthcoming, given that, otherwise, the Minister would have been implying that en-suite bathrooms did not constitute usable space, which would have been bizarre, even by the standards of the current Government?

Mr. Hammond: My hon. Friend is right. My point is that the process followed by the Government, if it were intended to introduce workable standards in an orderly fashion without damaging the market, has failed. Instead, that process has resulted first, in the breakdown of the negotiations that the Minister expected, wrongly, would reach enough of a conclusion to enable him to make an announcement to the Standing Committee; and secondly, in a lack of clarity about issues such as whether or not en-suite bathrooms and door-sweep areas are to be included. I am merely speculating, but, as the Minister makes announcement after announcement in an attempt to reassure the market, it strikes me that, in his efforts to make the arrangements workable, the Minister is having, time and again, to overrule civil servants who have led him seriously astray and left him with a system that would be unworkable and unaffordable.
7.30 pm
We still have no definitive answer to clarify the mystery of what the minimum acceptable room size will be. Similarly, we do not have a time scale for compliance in existing properties. We are still in a mess. I do not pretend that the new clause will solve all the problems. Clearly this is a matter of process rather than one of legislation. However, I believe that the new clause would lead to cleaner, better, more informed and more transparent processes for arriving at national minimum standards. It would ensure that the Minister had all the relevant information. To put it bluntly, he would be able to see the size of the bomb crater that he would create in


his own backyard before he published the draft standard. There would then never be a danger of disrupting a market by allowing rumour and speculation to get a hold.
Critically, the new clause will provide for proper parliamentary scrutiny of these most important parts of the regulatory system. I suspect that my hon. Friends will agree strongly with me that it is outrageous that a key element of the Bill, which could destroy people's businesses and livelihoods, should lie outside and beyond the scrutiny of Parliament.
I hope that the Minister will be able to give us some reassurance. Perhaps he will be able to tell us when he will make a definitive announcement, and what the time scale will be for compliance with the definitive room size that he determines. Of course, he will tell us that he is still in the process of consultation, and we have no objection to that. Indeed, it is valuable. However, we know that the Department can act when it has to. It managed to consult 12 million people in its so-called national health service survey in a fortnight. Apparently, it cannot talk to those responsible for about 17,000 care homes in much less than a year so as to get them on board and understand their responses to the consultation process. Meanwhile, individual owners of care homes and residents—those who live in fear of what will happen to their homes, many of them having gone into them expecting to live out the remainder of their lives there—are suffering from blight. Repairs are not getting done, and extension plans are being put on hold. The system has degenerated into chaos.
It is easy, tempting and convenient for government to express national minimum standards for care homes in terms of what is easily measurable—for example, the size of a room, the number of staff, the number of choices on a menu and the number of square metres available per resident in the day room. I have serious doubts about that, which I know are shared by other hon. Members on both sides of the House. Are we measuring what matters or what is easily measurable? What matters to those who are being cared for is the quality of care being delivered. The danger of introducing prescriptive national minimum standards is the elimination of choice and diversity.
It seems self-evident that if there is a given income—usually provided by a local authority—for housing a resident, it can be spent in several ways. For example, a larger bedroom may be provided, but there may be smaller areas of communal accommodation. Smaller rooms might be provided for both purposes, but there may be a vastly superior menu. There might be smaller rooms but a much higher staffing ratio, or much better qualified staff. There should be choices because different residents will have different needs. Someone who has limited ambulatory capability—in other words, someone who cannot walk about—will not have much use for elaborate day-room facilities. Someone who is active and sprightly may have little need for a large bedroom. It seems self-evident that there should be no one set of prescriptions to govern all the accommodation in the marketplace. That would have the effect of eliminating choice still further.
The new clause would improve on clause 23. It would ensure that future proposals for new national minimum standards were better informed. It should help to avoid shambles such as those created by the circulation of "Fit for the Future?" Crucially, it would allow for proper

parliamentary scrutiny of these vital national minimum standards, which have a huge impact on individuals and on the public policy agenda.

Mr. Hutton: I am listening carefully to what the hon. Gentleman is saying, and he is setting out his case clearly. Will he confirm what I think I heard him say? Is he saying that there should not be a national room-size standard for residential or nursing care homes?

Mr. Hammond: I questioned whether there should be rigid criteria which reduce choice and—[Interruption.] The record will show what I said. I shall clarify what is in my mind and what concerns me. The Minister knows of my concerns because he has heard me express them before. I believe that different people have different needs and different wants. We are talking about people, not statistics. There needs to be enough flexibility in the system to cater for people's diverse needs and wants.
In an ideal system, we could have 12 sq m rooms for everybody, and payments high enough to allow care homes to provide additional services. However, if resources are constrained so that we are forced into choices, surely it is better not to lay down certain criteria and state that they will apply to all care homes, but to lay down some variable geometry. That might be sensible. Some care homes might provide better bedroom accommodation and fewer communal facilities. Others might provide better communal facilities and less bedroom space. One category of home will appeal to one category of resident and another type will appeal to a different category.

Mr. Hutton: I understand what the hon. Gentleman is saying about the need for discretion in terms of a possible national minimum room-size standard. I shall take up his argument when I respond. However, does he think that there should be a national minimum room-size standard, perhaps subject to discretion?

Mr. Hammond: The Minister knows very well that minimum standards are required by local authorities, and that they vary from area to area. I can see advantages in having national minimum standards—but we must regard them as the minimum. As I said in response to an intervention from my hon. Friend the Member for South Dorset (Mr. Bruce), if we introduce minimum standards we run the danger of their becoming the normal standards.
If we introduce minimum standards at a level low enough to allow, within the resource envelope available, some discretion to provide above-minimum standards in other areas, we must always avoid the minimum standard becoming the norm. Some sort of variable geometry, which recognises the reality of a trade-off and takes into account the fact that different residents will have different needs and wants, is the way forward.

Mr. Burstow: I wish to clarify the hon. Gentleman's exposition. He is saying that there is a clear link between quality and costs, and that standards may need to be lower to accommodate the current financial envelope. Which is his preference? Is he saying that we should increase resources to enable a higher standard to be achieved, or that we should lower the standard?

Mr. Hammond: The hon. Gentleman misquotes me. I was saying that if we want room for discretion—and if


we want diversity there must be room for discretion—the minimum standards will have to be set at a level which leaves some resource in the hands of the provider, so that he can add to that minimum provision in one area or another. If the minimum standard in each area where a minimum standard is set—room size, staffing ratio, meals—is at a level which, together, consumes all the resource available to the provider, there is no possibility of diversity and variation between providers, and the consequence of that is no choice for those entering residential care.
Amendment No. 38 seeks to leave out from the powers to make regulations a reference to imposing
requirements as to the financial position of an establishment or agency.
The Bill seeks to level the playing field between public and private sector providers. It is unlikely that anyone will lay down requirements as to the financial position of a county council or unitary authority before it is allowed to operate or register a care home. Therefore, the provision allowing the Minister to set regulations regarding requirements as to financial position can only be taken to be addressed to private sector providers, and to open up again a distinction between private and public sector providers, which the Government have sought to close.
I am not sure what the criteria will be. The Minister knows that a considerable number of care and nursing homes operate in receivership. That, I am afraid, is the nature of the pressures in the marketplace. The Minister assured me in a letter that the provision that we seek to omit, which concerns requirements as to financial position, would not be used to disallow the registration of an operator merely because it was operating in receivership.
One's financial position cannot get much worse than operating in receivership, so I am not sure quite what the Minister has in mind. However, the provision will act as a barrier to entry. It will stifle new entrants to the sector if they are required to show a financial robustness which, typically, start-up businesses may not have. That would be a massive own goal for the Minister because competition among providers is essential to him in ensuring good quality and sensibly priced provision.
We also run up against the problem of who will make decisions about adequacy of financial position. By and large, the people doing the inspecting, registering and regulating will be people who know about the care and accommodation of frail elderly people, not accountants, and that is a major problem.
Amendment No. 39 will not get the attention that it deserves, but it is important, as it would enable the Minister to make regulations to
make provision in the case of an establishment providing cosmetic surgery
to control
the nature of statements that may be made with regard to the services provided; and…the titles that may be used to describe persons carrying on, managing or employed at such an establishment.
The first problem arises because there are many well-documented examples of misleading claims being made for cosmetic surgery and premises providing cosmetic surgery. The second provision is there because there is hard evidence that in some cases, people have been seen by, and indeed treated by, people who describe themselves as consultants, but who are sales consultants,

not medical consultants. Whether or not the Minister is prepared to accept the amendment, he will share the worry about the fact that that is going on. Those are areas of concern, and the amendment is simply intended to highlight them.

Mr. Burns: I add my support to the important new clause moved by my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond). However, I warn my hon. Friend that I have a grave reservation about part of it.
As my hon. Friend said, minimum standards are a fundamental part of the Bill and of its impact not only on care home owners in the private sector but on local authorities that still own and control residential homes.
As I said in an intervention on my hon. Friend, there is grave concern among many local authorities, not least Essex county council, about the bills that they will have to pay to upgrade their homes to a decent standard. For a variety of reasons, over the years some authorities have fallen behind in renovations and improvements, to the point where the cost of complying with any minimum standard issued by the Department of Health would be excessively high—and that is before we even come on to the issue of the quality of care. The quality of care could be, and in many cases will be, infinitely better than the quality of the buildings in which people may live.
Therefore, I am concerned about who will finance local authorities' need to improve their homes. As I have said, Essex county council has a real problem. It already spends significantly above its standard spending assessment on social services. As the Minister will know, there is no relaxation or abatement in the demands that are being put on social service budgets by the needs of the populations that they and local authorities have to meet. To have to find on top of that a significant amount of money to enhance their residential homes stock will be an onerous burden.
Has the Minister made any provision for helping local authorities through central Government grants to take that into account? Many hon. Members whose local authorities are concerned about that would be grateful if the Minister could deal with it when he replies.

Mr. Bercow: Given the financial constraints that local authorities face, does my hon. Friend agree that those authorities would welcome from the Minister tonight a clear idea of the timetable within which they will be expected to achieve the minimum standards that he favours? Does my hon. Friend also agree that it is incumbent on the House in taking forward the Bill properly to distinguish between desirable standards and those that are essential to human safety?

Mr. Burns: I am grateful to my hon. Friend for raising two crucial points. I hope that the Minister listened carefully to my hon. Friend's point about the timetable that the Government expect local authorities to use to bring the physical structure of their residential homes up to the standards required. With regard to the quality of care, there is probably no problem in the vast majority of residential homes.
My hon. Friend's second point is critical. It would be desperately perverse if residential homes were penalised because they were way above the minimum standard.


By definition, the service that they provided would be too good according to the criteria of the bureaucracy entailed in establishing any minimum standard. I hope that the Minister will bear that in mind. It would be terrible if care home owners were penalised because they had enhanced and improved, or were seeking to enhance and improve, the quality of their service way above the minimum standard

Mrs. Lait: I agree with my hon. Friend, but does he agree that the unintended effect of minimum standards could well be that local authorities get out of residential provision entirely, and such provision then becomes a private sector monopoly?

Mr. Burns: That is a logical conclusion to draw from the situation facing several local authorities. Particularly in the case of Essex, unless the Government are exceptionally generous in providing ring-fenced additional money to help authorities deal with their residential home stock, local authorities will have to sell those homes into the private sector. If they do not, the homes will not reach the minimum standards that the Government plan to establish. Presumably, they would then have to be closed down, and that would be intolerable.
I do not entirely agree with the conclusion of my hon. Friend the Member for Beckenham (Mrs. Lait) that it would necessarily be a bad thing for local authority owned residential homes to move into the private sector. There is a great deal to be said for that, particularly in view of the problems that the public sector has faced for many years because the financial resources have not been made available to it by central Government to allow it to keep pace with the standards and quality of private homes.

Mr. Swayne: Will my hon. Friend give way?

Mr. Burns: Briefly.

Mr. Deputy Speaker: Order. Before the hon. Gentleman gives way, I appeal to him to face the Chair.

Mr. Swayne: Given my hon. Friend's inference that the provision is a potentially welcome privatisation measure, those on the Treasury Bench no doubt welcome the fact that there is not a single Labour Back Bencher present to hear the real consequences of the Bill.

Mr. Deputy Speaker: Order. We do not need to worry about who is not in the Chamber. We are in the Chamber. That is the important thing.

Mr. Burns: I echo the comments of my hon. Friend the Member for Runnymede and Weybridge about minimum standards. When Governments start laying down minimum standards, there is a danger that an attitude of mind develops, and that what began as a minimum becomes set in stone. The troubles multiply as people try to enforce the minimum standards. If they have got it wrong in any way, tremendous problems can result for the care home owners providing residential care and nursing care to our citizens.
Similarly, as my hon. Friend pointed out, there is considerable uncertainty about what the standards will be and how much parliamentary scrutiny the process of establishing them will receive. I assume that the Government intend the standards to be a movable feast as changes are needed in the light of experience and developments in the provision of residential care and nursing care for members of the community.
There is one aspect of my hon. Friend's new clause about which I have serious concerns. I do not criticise my hon. Friend lightly, because he does not deserve criticism, but part of his new clause suffers from what may tactfully be described as careless or ambiguous drafting. I refer to subsection (4)(b)(ii).
Under subsection (4), the Secretary of State shall
consult such persons as he considers appropriate
and
request the Commission to give him advice as to the likely impact of the proposed statement or the proposed amendment
on, according to subsection (4)(b)(ii),
the cost of supplying such services in accordance with the statement of minimum standards.
As I suggested to my hon. Friend in an intervention, the reference to the cost of supplying services could mean one of two things, or possibly both. It could mean the cost to the supplier of the service—the owner of the care home—or it could mean the cost to the person using the service.

Mr. Hammond: I do not want to engage my hon. Friend in a detailed grammatical debate, but I feel obliged to defend myself. It seems to me that the cost of supplying a service can be incurred only by the supplier. The cost of purchasing a service will be incurred by the purchaser.

Mr. Burns: I thank my hon. Friend. His knowledge of the construction of the English language is probably superior to mine. I do not want to continue to argue with him, and I accept his clarification, but that has implications for the person to whom the service is supplied. There should be a sub-paragraph (iii) referring to the cost to the user of the service supplied in accordance with the minimum standards.
I have good reason for considering that to be important. The sheer horror of the situation will become apparent only next Tuesday. I expect that the Minister saw or had drawn to his attention the main story on the Channel 4 news last night. I do not know how many of my hon. Friends saw it. The subject, which has a serious impact on many hundreds of thousands of elderly people and their families, was the leak of what the comprehensive spending review to be published next Tuesday will say about long-term care, its cost and how that will be met.
As the Minister will remember, although he was not at the Department of Health at the time, the former Secretary of State, when announcing the royal commission, said that it must complete its work swiftly. The original timetable set was 12 months from its inception in the summer of 1997. Because of the sense of urgency and the rhetoric, we expected the Secretary of State to consider the recommendations and make an announcement to the country fairly swiftly.
The 12-month period would have ended in July or August 1998. It is now July 2000 and we have not heard a single word from the Department of Health about how


it is to move forward. I understand from the Channel 4 report last night—this will have a direct bearing on new sub-paragraph (iii), which I urge my hon. Friend to include in new clause 4—that the state is to pick up the bill for nursing care in nursing homes. The Government would be absolutely right to make such a decision. The difference between what the health service should provide and what the individual should pay for has become increasingly blurred as the National Assistance Act 1948 has become more and more irrelevant to society's changing needs over the past 52 years. If that is what the Government intend to do, it is a step in the right direction.

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Mr. Collins: The powerful case that my hon. Friend is developing seems to be an argument in favour of new clause 4. The Minister may be reluctant to accept subsection (4)(b)(ii) because the only advice that the Secretary of State will wish to take will be that of the Chancellor, who will tell him what he can and cannot spend. The Secretary of State has no interest in independent, possibly awkward, advice.

Mr. Burns: My hon. Friend makes an extremely pertinent point in his correct analysis of the thinking in the Department of Health. He identifies the straitjacket within which Health Ministers must operate. They have received different moneys from the Chancellor for hospital and medical care, and I imagine that the Chancellor thinks that enough is enough.
As Channel 4 said last night, pensioners will now be hit with a double whammy—the miserly 75p a week increase in pensions this April and the announcement—

Mr. Deputy Speaker: Order. These matters are worth mentioning given that some people live on fixed incomes or are in long-term care, but the hon. Gentleman must not make a meal of them.

Mr. Burns: I am grateful for your guidance, Mr. Deputy Speaker. In conclusion on that point, then, I feel that the new clause should include a subsection (4)(b)(iii). The Government will apparently announce on Tuesday that they will not fund long-term care. They may raise the £16,000 threshold, but will still expect families to sell their homes to pay for long-term care. That takes us to the need for an analysis by the commission or by those whom the Secretary of State consults of the costs of the minimum standards to the users of the services. Those costs must include the costs to families or individuals for living in a residential or nursing home.
We shall not know until Tuesday whether Channel 4 was accurate, but if it was, there is even more need for a change to new clause 4. It is, of course, too late to amend the new clause tonight. I shall support my hon. Friend the Member for Runnymede and Weybridge if he wishes to pursue his new clause, but, without being unduly unfair to him, repeat that it is a pity that my additional proposal is not in the new clause.

Mr. Burstow: I support the new clause, which provides a basis for exploring the Government's attitude towards national minimum standards and the process by which we have reached our present point. The Bill is primarily a vehicle for a series of regulation-making powers, giving

the Minister powers to redefine and rewrite large chunks of the Bill. It also gives the power to introduce minimum standards in a range of differing care settings, and we must be clear what the role of the House will be, not only in passing the Bill, but for the future when standards are introduced.
The Standing Committee explored in some detail an issue that we must revisit—the need for a clear and transparent process that gives the House and the other place an opportunity to debate both the statutory instruments that give effect to national minimum standards and those standards themselves. As we know from "Fit for the Future?", the standards will contain an awful lot of detail, and many devils lie in the details, which has raised much concern outside the House.
The debate about national minimum standards is at least in part motivated by understandable anxieties among care home owners, and all Members will have had representations from them. It is important to record, however, that minimum standards exist for the safety and security of the consumers of the service, and act as a guarantee for them. That should be our starting point in constructing any minimum standards. I entirely accept that legitimate concerns exist about minimum room size, staffing ratios and so on. We must address those questions, but other standards—identified in "Fit for the Future?"—are welcome and should be implemented at the earliest opportunity.
The debate about minimum standards will of necessity be better informed if we consider what has happened to date rather than talking only in the abstract about future domiciliary care, day care or any other type of care. It is crucial to bear in mind that a key element underlying minimum standards must be the principle of maintaining the independence and dignity of people in care. We must consider how to provide choice and how to ensure as much control as possible for the individual. "Fit for the Future?" covers such issues as social activities and other measures of quality that ought to be covered by minimum standards. I do not see room size as an adequate proxy for quality.
That said, we must recognise that standards change over time and cannot be absolute. My generation may expect something different in a care home from what a future generation will expect. Perhaps there are differences in what those living in care homes expect. Those differences should be borne in mind. Equally, on choice, someone living in a care home may have chosen a particular location because it is a listed building with unique features. That may be the very reason why that person has chosen that home, and we should not lose sight of that fact as we implement standards. It would be wrong to drive out of business a home in which people are receiving the quality of care and life that they want just for the sake of complying with a minimum room size standard.
The regulatory impact assessment attached to "Fit for the Future?" said that 7,000 additional nurses would be required to give effect to the national minimum standards. We know all too well from questions and debates that the Government are struggling to recruit and train enough nurses to fill the 17,000 vacancies in the national health service. To suggest that we can find another 7,000 beggars belief. As we consider "Fit for the Future?" and the emerging national minimum standards, we should be given clear timetables showing when consultation will end


and when ministerial deliberations will be concluded. That would provide the maximum possible clarity on the minimum standards, which the industry—home care, day care or care homes—wants.

Mr. Bercow: I agree with the thrust of what the hon. Gentleman says, but may I focus his attention on Government amendment No. 61? Given that clause 22, which will be amended under that amendment, contains no fewer than 10 subsection and 34 paragraphs, what precisely is the merit of, or the need for, Government amendment No. 61?

Mr. Burstow: That is an interesting point. When the Minister responds, we may discover that the Government are attempting to respond constructively to concerns that were expressed in Committee by the hon. Member for Runnymede and Weybridge (Mr. Hammond). The hon. Member for Buckingham (Mr. Bercow) may have to wait to listen to the Minister's gracious comments on those matters.
In Committee, several hon. Members expressed concerns about the impact that standards would have on the supply of places in care homes, but the availability of domiciliary care is also important. The Government need to accept that there is a crisis of confidence in the care homes sector. How many homes are closing in any given week may be a matter of dispute, but I have heard that one a week, possibly more, are closing. They may be closing for the perfectly legitimate reason that they do not provide a good standard of care. Such homes should be closed, but many others are closing because they cannot provide a decent rate of return on the investment that they have made in their businesses.
Fees have not kept pace with costs. That key problem predates the Bill and national minimum standards, but the uncertainty about those standards has added fuel to it. As the hon. Member for West Chelmsford (Mr. Burns) has said, local authorities are under financial pressure on the provision of social care and the increasing demands that are placed on them. As a result, they must be ruthless in exercising their role in purchasing care places. They are undoubtedly holding down fees as much as they can. There have been some increases, but they have not been adequate in many cases.
The link between quality and the cost of meeting the standards is not straightforward. The equation is more complicated than that, but there is a link. If the standards are driven up—I would entirely applaud and support that—it must be recognised that, at some point, that will have a bearing on the fees that need to be charged and the incomes that need to be provided. We shall expect care assistants and others involved in domiciliary care and care homes to receive more training to meet the new national minimum standards and to ensure that adequate numbers of staff are registered with the commission.
All too often, better trained staff look for better paid jobs. Care assistants in care homes are not paid decent salaries. They can get better pay stocking the shelves at the local supermarket. If we do not recognise that problem, we shall store up problems for ourselves. There will be a flight from the sector as a result of improving the qualifications of its staff because they can get better jobs in other aspects of social care, where their skills are more fairly rewarded.
The hon. Member for West Chelmsford, who is no longer in his place, rightly expressed concern about the link between improvements in standards and the potential increase in costs to the consumers—those who live in care homes. He linked that to reports of yet other leak about what the Government have in mind for long-term care and the relative distribution of the consequent costs between the state and the individual. We shall have to wait for the White Paper, rather than the comprehensive spending review, to find out whether the leak is true.
If "Channel 4 News" is to be believed, I hope that the Government, even at this late stage, will give further thought to what the Prime Minister said before the general election. He said that he did not want to live in a country where old people had to sell their homes to pay for their care. The many hundreds of thousands of people who thought that the Government would take serious action on that feel betrayed and let down by the Government in that respect.
8.15 pm
We shall have to wait until next week to find out whether the comprehensive spending review will provide a true idea of exactly what sums will be allocated to such matters. Time will tell, but I fear that we might have to wait until the White Paper is published, I hope, at the end of the month.
If the hon. Member for Runnymede and Weybridge decides to press the motion to a Division, we shall support him. New clause 4 proposes an entirely right and proper structure in which the Government should discharge their responsibility to produce minimum standards. The House should have a clear role in scrutinising those standards. Its role should involve much more than approving a statutory instrument under the negative procedure. The affirmative procedure should be used, so that we can consider not only the regulations, but the details behind them. I hope that the Minister will be able to respond positively.

Mr. David Amess: I do not want to fall out with my hon. Friend the Member for West Chelmsford (Mr. Burns), but I congratulate my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) on his skilful drafting of new clause 4. I found his arguments entirely convincing and hope that the Minister will accept new clause 4.
The Minister will know from our deliberations in Committee, that I feel very strongly about such matters. There are a huge number of residential and nursing homes in Southend. That should be no surprise because it is well known that Southend is the finest seaside resort in the country and elderly people are flocking to the town because the movement of the Thames estuary is extremely good for people's breathing. That is why our residential and nursing homes are so popular, especially those in Southend, West. I regularly visit those homes and I am in constant contact with the people there.
The Minister takes a different view, but of course Conservative Members support national minimum standards. That is well understood, but he is saying "Trust the Government." I, for one, do not trust the Government. I am very concerned about those standards. As the Minister knows only too well, this is not about the curtains, the en suite facilities or similar matters, but about the love and care that many elderly people in those homes


are given by the home owners. I baulk at using the expression "running their business", but it is not good enough for the Government to expect the owners of those homes to do whatever the Government want without proper and due consultation.
I take my hat off to the Minister; he was kind enough to invite the Committee to 79 Whitehall to look at the different rules and regulations on which he was consulting. However, I ask him to consider new clause 4 carefully because it would be a tremendous fillip to all our residential home owners if it were accepted. He knows only too well that the Independent Healthcare Association, Leonard Cheshire, the National Care Homes Association, Help the Aged, William Laing and others have all been somewhat concerned about the overall tenor of the minimum standards.
Perhaps the Minister will tell us that he has managed to placate those concerns in the past few days, but the magazine, "Caring Times" carried out a survey to discover the effects of "Fit for the Future?". That survey should be of concern to the Minister because more than 50 per cent. of respondents said that they could be obliged to close due to bankruptcy.
We all know from our constituencies that the national health service is in crisis. My goodness, I experienced that myself at St. Thomas's accident and emergency unit in the wee hours of the morning on Monday, learning at first hand how the NHS is in great difficulty. Many of our constituencies are experiencing bed blocking. We have 56 people in hospital at the moment—

Mr. Deputy Speaker: Order. The hon. Gentleman's remarks are wide of the new clause; he may want to return to discussing it.

Mr. Amess: Of course, Mr. Deputy Speaker.
A residential home proprietor in the north-east said of minimum standards:
Basically, this is another idea developed by those who do not know and never ask.
A nursing home proprietor in Scotland said:
We are negotiating a loan to improve our facilities and have been experiencing difficulties with lenders directly due to the possible implication of these proposals. We are now having to alter plans and hope this will satisfy lenders. This will increase our loan and without an adequate increase in fees, budgets will be very tight. These are onerous standards, financially wasteful and will threaten small establishments.
That is why we need the Minister's reassurance that there will be due and proper consultation. For that reason, I am an enthusiast for new clause 4. The Scottish proprietor continued:
The larger homes can easily absorb costs. Is this the future—the large pies controlling the care sector?
That is another concern.
I do not want to cause controversy in Southend, West, but when I go round residential nursing homes and see chintzy curtains and plush facilities, I am not taken in for a minute. I am concerned about the quality of care. I have first-hand experience because next door to me is an excellent residential nursing home called Cherry Croft, and I pay tribute to the loving care and nursing that it gives to many of my constituents. However, I also have first-hand experience of another nursing home outside the area that I represent, although I shall not go public on that

as I am trying to deal with the matter tactfully at the moment. One would think that the home is the cat's whiskers, but I happen to know that the care and attention that it provides are somewhat disappointing to say the least and there have been unfortunate outcomes.
Recently, I had the privilege of visiting a small home with only eight beds in my constituency. It is struggling, and it told its Member of Parliament that it is struggling because it is concerned about minimum standards. It is looking for certainty, as it wants to plan for the long term. The people there love their residents, but they think that, unless there is the certainty that new clause 4 would provide, the home may have to close, adding to the 50 per cent. of homes that believe that they will have to close.
A residential home owner in the midlands said:
We've just spent a fortune upgrading to existing standards. If new standards are introduced, we would have to close. Residents would lose their homes, staff would lose their jobs and we would be devastated.
That is happening right this minute in the midlands. Linda Nazarko, the director of the Registered Nursing Homes Association, said:
Standards must be meaningful, and concentrate on quality, not merely on physical standards… The RNH is 100 per cent. committed to quality care but have been saying for some time that it is unjustifiable to raise physical standards any further in a climate of decreasing resources.
That is a different argument, but we should not completely reject the points that she has made.
A residential home proprietor in the south-west said:
We comply with all the current regulations. I have difficulty comprehending how an increase in bedroom size can have that great an effect on the care and wellbeing of our residents. The vast majority spend no waking time in them whatsoever. We employ more care staff per week than the basic requirement, our staff are comprehensively trained and care is of the highest standard. These standards would bankrupt us. Eighteen residents would be homeless. Twenty-four staff, many of them breadwinners, would be unemployed.
Another residential home proprietor in the south-west said:
In our experience, most of our residents have used the bedroom only for sleeping in at night and a few for a nap after lunch.
Recently, I attended a reception at which home owners gathered to debate the national minimum standards and I say to my hon. Friend the Member for Runnymede and Weybridge that I found them overwhelmingly enthusiastic about the proposals in new clause 4.
I have received a letter from the Norfolk Residential Care Homes Association, which is very concerned about minimum standards. It says:
We are seeing Home closures in Norfolk which result in residents being transferred up to 20 miles away
and that is
a problem for relatives and friends for…maintaining contact
with their loved ones. I have also been contacted by the Brighton and Hove National Care Homes Association. It, too, is very concerned and I am advised that 17 of every 20 care homes for old people in Brighton and Hove—85 per cent.—will close as a result of the minimum standards. The councillor dealing with this matter said that the Conservatives were scaremongering and that the closure rate would be only 30 per cent. That is no comfort to the good people of Brighton and Hove.
I ask the Minister to consider carefully the arguments made by my hon. Friend the Member for Runnymede and Weybridge. I support minimum standards—they are desperately important to the living standards and living conditions of elderly people—but where is the measure for the love, care and devotion that many home owners give to residents? An overwhelming number of residents have no relatives and might have lived in a home for 10, 15 or 20 years. They may not have en suite bedrooms or rooms that meet the standard that the Minister has in mind, but none of that is important to them. They do not regard home owners as wicked capitalists. In fact, morning, noon and night, they put their hands in their pockets to make sure that standards for residents are decent and they also celebrate residents' birthdays and provide all sorts of entertainment. None of that is recognised in the minimum standards.
I know that the Minister has the best intentions, as he showed in Committee, but we need to be convinced that the minimum standards are in the best interests of residents. I hope that he will reconsider new clause 4.

Dr. Brand: I am sure that the motives behind "Fit for the Future?" were right, but it has caused great concern, mainly because it does not necessarily address the issue of fit for the purpose. I have been struck by the complaints. Small care home owners are concerned about rigidity—the bricks, mortar and buildings—and are relaxed about the excellent quality standards for care and staffing. Conversely, the larger providers—those quoted on the stock market which run large granny factories—were relaxed about the bricks and mortar, but extremely concerned about meeting the staffing levels and qualifications. There is no doubt that care is more to do with staff than with buildings.
It is right that the Government should set minimum standards for staffing and training, which are vital. We should commend the Minister for his efforts in that area. However, minimum structural standards for care homes could be best addressed through ministerial guidelines to the commissioning agents. Different homes suit different people. That is not only because different personalities are happier in different settings, but because their physical, emotional and social needs may be different.
It would be sad if a fixed ratio were imposed on the double occupancy of bedrooms, as opposed to single occupancy. Even in a place such as the Isle of Wight, there are cultural differences. In one part of the island, it is the norm to share. In other parts, everyone wants an en suite room and not to talk to anyone else. We must accept that that is part of giving residents choice.
The issue of communal facilities has been mentioned. In nursing homes dealing mainly with post-operative conditions, people spend a great deal of time in their bedrooms. They do not want to go out, mix or sit in a dining room. They want to rest in peace and quiet and then go home. If that is the business that the establishment is in, it seems unreasonable that it should be required by regulations to have facilities that it does not use.
In Committee, I supported the imposition of statutory standards by affirmative resolution, but these should be backed by ministerial guidelines which, in time, may

show where statutory standards may go in the fullness of time. That will help health authorities and local authorities in their commissioning role. There is a need for standards to rise even in places such as the Isle of Wight, where we have done well at the expense of some less effective and less successful home owners. One must accept that we are dealing with a part of the business sector, and that businesses should compete. With that goes grief from time to time.
There is no doubt that what is happening to the sector is unreasonable. One of my slight criticisms of new clause 4, which is well drafted, is that it does not give a time scale for consultation. Consultation is vital. The Government consultation on "Fit for the Future?" was announced in October last year and it took until a week after Christmas before I could get copies to the people affected by it. It was difficult to get responses in within the deadline and, when people put in their responses, nothing happened. In the meantime, we have had a long period of uncertainty, which is having a detrimental effect on investment in raising standards and on those who were about to retire, but cannot at the moment.
We have rehearsed the arguments and we have heard indications of comfort, but no real comfort from the Minister. I hope that he will go further than he did in Committee.

Mr. Hutton: First, I wish to explain to the hon. Member for Buckingham (Mr. Bercow) why amendment. No. 61 has been tabled. The amendment will place an obligation on the Government to consult the people and bodies whom they think appropriate before making any regulations under clause 22 and before making any significant amendments to regulations made under clause 22. In tabling the amendment we are responding to concerns raised by the hon. Member for Runnymede and Weybridge (Mr. Hammond), who raised the issue in Committee. I assured him then, and I confirm today, that it was always the Government's clear intention to consult on all the regulations made under this clause. However, I am happy to table this amendment to put the matter beyond any reasonable doubt.
I hope that the hon. Member for Runnymede and Weybridge will be pleased to see that we have actually gone further than his amendment would have required, in that we have included a requirement to consult on any substantial changes to regulations that have already been made under this clause. I hope that that will be welcomed by the hon. Gentleman and his colleagues.
We have had a wide-ranging debate about some other issues, particularly new clause 4. This is a familiar theme to those Members who take an interest in national minimum required standards. The hon. Member for Southend, West (Mr. Amess) spoke with his usual passion—if not accuracy—about the subject. The hon. Member for West Chelmsford (Mr. Burns) spoke with substantial knowledge, gained from his time as a Health Minister. I thought that his contribution was important and useful.
The hon. Member for West Chelmsford explained the difficulties that he had experienced in his own county, Essex. It is my own county, too; I lived there for many years.

Mr. Keith Simpson: An Essex boy!

Mr. Hutton: Indeed.

Mr. Stephen Day: That explains a lot.

Mr. Hutton: It might explain a few things, but I do not think that we should go there today.
The hon. Member for West Chelmsford was explaining some of the problems that small care home owners in Essex were experiencing primarily with the room size standard. He will be aware that the problem in Essex perfectly illustrates the need for the changes in the Bill and the new laws that we are proposing. Essex county council has had a 10 sq m standard since 1991, and the council gave care home owners 10 years to comply with the standard. The hon. Member for Southend, West was moaning about the standard, but it was introduced nearly 10 years ago in his constituency and that of his hon. Friend the Member for West Chelmsford. To be fair to both hon. Members, I must say that I have no information about the extent to which the standard has been implemented by the county council and, in particular, the social services department. It may be possible for us to correspond about that.
The hon. Gentleman was concerned about the fact that the county council had never applied the standard to its own homes. In the Bill, we are creating a level playing field between the public and private sectors. I should have thought that the hon. Gentleman and his hon. Friends would at least welcome that advance.

Mr. Burns: Will the Minister give way?

Mr. Hutton: I will in a minute. Conservative Members have taken nearly an hour and three quarters; I have spoken for four minutes.
An important point has been made today—all who have spoken made it effectively. We have tried to make it too; certainly, I made it repeatedly in response to the concerns expressed by the hon. Member for Runnymede and Weybridge in Committee. We absolutely must get the emphasis right. The quality of care must be measured accurately, and that cannot always be done with a tape measure.
Not all hon. Members—although, to be fair, the hon. Member for Isle of Wight (Dr. Brand) probably came closest to it—have sufficiently stressed the importance of room sizes as a measurement of quality. We should ask ourselves whether, if we were going into a care home, we would want to be in a small room, or in a reasonably sized room. The hon. Member for Southend, West said that some care home owners were saying, "These people do not spend much time in their bedrooms." We should bear in mind, however, that in a typical residential or nursing home the bedroom is probably the only private space for residents.
The care home owner may believe that a resident is not spending much time in the bedroom. That is an observation. It must be recognised, however, that for many people the size of the room is an important issue. I am certain that, whatever hon. Members on either side of the House may say, it would be important for us if the time arrived for us to be in care homes.

Mr. Hammond: The Minister asks whether any of us would want to be in a small room. Viewing the question

in isolation, everyone would probably prefer the idea of a larger room; but we cannot consider such questions in isolation. If limited resources are available, choices must be made. That, I think, is the point that some of my hon. Friends have been trying to make.

Mr. Hutton: Obviously, the hon. Gentleman is right. The whole process of government and decision making in this place is about making choices. I will not pretend that we do not have difficult choices to make in setting national minimum required statements; of course we do. It would be naive to imagine that we could sail through it without having to make difficult judgments. What planet does the hon. Gentleman live on?
Of course these are difficult issues. That is why the process is taking time—that is a matter of record; it is taking time to make the right decisions, but we are determined to get them right.

Mr. Bercow: A couple of minutes ago, the Minister referred to room sizes, in the plural. In the light of his earlier challenge to my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond), will he confirm that he is irrevocably committed to a single national minimum room size?

Mr. Hutton: I do not know where the hon. Gentleman has been for the past 12 months or so, but he has obviously not been following this debate.

Mr. Bercow: I have.

Mr. Hutton: The hon. Gentleman may have been following it closely, but if he has I am surprised that he should ask such a question.

Mr. Bercow: I have a family interest.

Mr. Hutton: I am pleased to learn that.
We have always made it clear that we want to establish proper national minimum requirement standards, and those standards will include room sizes. My grammar may be wrong. I have been picked up on that a few times before in this place and I am sorry if I confused the hon. Gentleman, who is obviously punctilious in his use of grammar. If it is easier for him to come to terms with "room size", that is what I am talking about.
If the hon. Gentleman is as familiar with "Fit for the Future?" as he says, he will know that we are talking about the separate room-size requirement in relation to nursing homes, as opposed to residential care homes. We have postulated the possibility of a different room size for residents who are permanently in wheelchairs, for instance. I am afraid that the suggestion that we ever discussed just one figure makes me less convinced than I otherwise would have been that the hon. Gentleman was paying as close attention as he would have us believe.
8.45 pm
Let me now deal with amendment No. 39. We consider it important for prospective patients to receive clear and accurate information about the treatment and services that are proposed. The Bill already contains scope for that in clause 22. The power that we already have, enabling


regulations and standards to be produced in relation to patients information requirements, is more flexible than the power in the amendment.
The Government's response to the fifth report of the Select Committee on Health on the regulation on independent health care, produced in 1999, was that the powers in the Control of Misleading Advertisements Regulations 1988 were sufficient to control advertising. That, of course, is a matter for the Advertising Standards Authority and the trading standards departments of local authorities.
The amendment also deals with the question of the medical titles that people might use in cosmetic surgery clinics. As the hon. Member for Runnymede and Weybridge will know—he conducts his research carefully—section 49 of the Medical Act 1983 already makes it an offence for any person to pretend to be, or use the title of, a physician, Doctor of Medicine, surgeon, general practitioner or Licentiate of Medicine—I must say that in my travels across the country I have never come across anyone who has described himself as that. I think we have the right balance: there is already enough legislation to prevent such problems, and section 49 of the 1983 Act triggers liability for criminal sanctions.
Amendment No. 38 concerns the financial position of establishments and agencies. I cannot accept the amendment, which would remove a key power to ensure the protection of vulnerable people who depend on regulated care services. The purpose of this express power is simply to ensure that the establishment or agency is and remains financially viable. Would-be providers must be able to demonstrate that they have the means to run their businesses properly. Establishments or agencies providing care must be financially sound; otherwise, service users who depend on them will be put at risk.
The hon. Member for Isle of Wight rightly said that the focus of all this work should be on the consumers—those who live in residential homes. That is what the provision is about. It will, I hope, prevent unreasonable and unnecessary movements between care homes.
The principle was recognised in recent case law relating to fitness under the Registered Homes Act 1984, and therefore already forms part of the existing regulatory arrangements. In that case, the registration authority proposed to refuse registration on the ground of a lack of financial viability. The case was referred to the High Court for judicial review. As the hon. Gentleman knows, the care home owners challenged the decision. The court upheld the registration authority's view. The judgment confirmed that the consideration of the way in which it was intended to carry on the home must include the means available to provide the facilities and services.
The hon. Gentleman spoke of intrusiveness, but I think that most sensible people will see the power as simply a demonstration of common sense. Of course we need the provision in the Bill, and I would not advise my right hon. and hon. Friends to remove it.
I accept that our proposals may require commercially sensitive information to be made available to the commission, and I fully appreciate some of the concerns raised by the hon. Gentleman. However, as I told him in Committee, such information will be confidential, and the commission will have to observe high standards of

security in respect of it. Not to allow the commission to be able to satisfy itself about these matters would make it harder, not easier, for it to do its job properly. That should be our yardstick.

Mrs. Lait: Could the Minister clear up a point of confusion on a slightly different subject? Close care sheltered housing, quite rightly, will be regulated. However, on 14 June, in a debate on sheltered housing in Westminster Hall, the Under-Secretary of State for the Environment, Transport and the Regions, the hon. Member for Sunderland, South (Mr. Mullin), said:
The Care Standards Bill…will introduce the regulation and inspection of all types of home care provision, including that provided in sheltered accommodation.—[Official Report, Westminster Hall, 14 June 2000; Vol. 351, c. 270WH.]
Does that refer to all sheltered housing, or just close care sheltered housing?

Mr. Hutton: If the hon. Lady will forgive me, I should like to look at that reference myself and confirm—[Interruption.] She is waving it at me. I cannot actually read it from here, but I am sure that we will have a chat about it in the Lobby in a minute. We tabled amendments to the Bill to make it clear what type of care homes we wanted to regulate. We do not intend to extend the category of homes currently being inspected and regulated by inspection units. We have tabled amendments to put that beyond reasonable doubt.
The difficulty is, as the hon. Lady will be aware—she has much experience in the matter—that none of those categories of sheltered housing is legally defined anywhere. Therefore, we have made clear in the Bill which care homes we think the new powers should relate to. We have tried to reassure care providers that the Bill will not widen or broaden the scope of registration. I hope that that clears up the point for the hon. Lady.
There has been substantial discussion on new clause 4 and amendment No. 2. They have led to a long discussion tonight, and the same subject led to extensive discussions in Standing Committee. New clause 4 goes to the nub of the Bill—how we intend the new regulatory system to work in practice, and the impact that it may have on the viability of some the establishments and agencies to be regulated. When debating these matters it is important that we maintain our primary focus on the benefits of the Bill's changes for the people—children, young adults and older people—who use the services that we intend to regulate.
Those people are at the heart of our regulatory reforms. It is important to know how vulnerable they are to shoddy, negligent and, in some cases, abusive care. We know that there are some operators who should not be in the business of providing care, whose performance damages the reputation of decent providers and has led to the destruction of public confidence in some areas. Our intention with the Bill is to establish a proper regulatory system that promotes good quality care services and supports those many providers—the vast majority, in fact—whom the public can rightly trust. Therefore, I want to argue against the amendment tabled by the hon. Member for Runnymede and Weybridge, both in substance and in practice. It should not be part of the Bill.
The regulations will, as it were, form the bones on which the minimum standards will be the flesh. The current system works similarly, but the main difference is


that under the present arrangements there are no national standards; there are only local standards. We want a level playing field between different providers. The independent sector has been calling for national standards for a long time—a point that was never acknowledged by Opposition Members during the debate. That is what we intend to deliver, but consistency must be balanced with discretion.
In Committee, much of the debate on standards centred on "Fit for the Future?", the draft standards for care homes for older people. Through consultation, we established that nine of the 11 topic areas were widely supported. Standards cover fundamental aspects of quality of care for residents. They introduce principles of dignity, privacy and choice, and demand that residents are treated with respect by properly trained, competent and trustworthy staff. Two controversial areas—room sizes and staffing—have provoked concerted opposition from some sectors of home owners, especially owners of smaller homes, and opposition from owners in certain parts of the country rather than others. The wide variation in standards is in itself an argument for more consistency nationally.

Mr. Burns: On the question of national consistency and a level playing field, can the Minister answer the questions about how local authorities will be able to fund the upgrading of their residential homes?

Mr. Hutton: I want to say something about resources in a minute. Labour Members still have to be persuaded that the hon. Gentleman and his friends are the right people to hand out any lectures about the level of public funding and public support for some of these important social services. His party, I understand, has something of a widening gap, or black hole, in its public sector finance policies after some of the recent announcements and U-turns by his right hon. and hon. Friends.
Of course, the hon. Gentleman will be aware—again, because of his interest in the subject—that the Government are making record resources available to finance social services. The present comprehensive spending review provided nearly £3 billion-worth of additional expenditure during this period. There will be more to come. He will have to wait for those announcements, like everyone else, but the general financial situation is a positive one for local authorities and social services, with record resources going into those sectors.
I was referring to two controversial areas that have caused legitimate concern. On staffing, I have already stated our intention to base trained nurse staffing levels on assessment of need rather than fixed ratios. That should be of considerable help to many small nursing home providers.
On room sizes, it is important to state that 10 sq m is a reasonable norm, long established and widely observed. However, to balance consistency with discretion and to try to respond to some of the concerns that many hon. Members have expressed, I am considering criteria within which some flexibility can be exercised on that standard, to allow rooms smaller than 10 sq m to remain in use. I hope shortly to be in a position to provide the House, especially hon. Members who have an interest in the matter, with a fuller explanation of what the minimum

required standards will specify. However, let me make it clear that there is no intention to prevent good quality homes from continuing to operate. We want to preserve the stability of provision for residents.
Turning to the specific provisions of the amendment, the commission will have access to important information about the state of the care sector and will be able to advise the Secretary of State accordingly, but I personally do not believe that it is the commission's role to advise on standards in terms of their effect generally, or on the costs of their implementation. I believe strongly that that responsibility rests squarely with the Government. That is ultimately where it should remain.
The issue of consulting on standards was well aired in Committee. We have given clear undertakings to consult on standards and on regulations, and the latter will be laid clearly before Parliament. Draft standards will also be made available to hon. Members for consultation.
In Standing Committee last week, I extended to the hon. Member for Runnymede and Weybridge, who speaks for the Opposition on these matters, an opportunity to participate in some of the consultations on the Children (Leaving Care) Bill. I am more than happy to extend such an invitation in relation to the national minimum required standards to all the right hon. and hon. Members who speak for their parties on social services issues.
It is self-evident that no establishment or agency will be registered unless it complies with the standards, and of course the regulations; otherwise there is no point in having them. That is one other reason why the hon. Gentleman's amendment adds nothing of value or substance.
I have tried to address some of the concerns that have been raised in the debate. I do not want to go into all the nooks and crannies of the hon. Gentleman's description of proceedings in Standing Committee, but I do not think that he gave a completely accurate description of the exchange that we had on those issues.
The hon. Gentleman referred in particular to a letter that I had written him, which he said indicated that we were not going to include en suite bathrooms in the standard. There was not, and is not, any such letter. The letter dated 6 July that he mentioned referred to the door-sweep implications. I have in front of me a copy of the letter that I signed dated 6 July—I remember it clearly—and it does not refer to en suite bathrooms. My recollection is that we had an exchange on the subject in Committee. Although I do not remember the exact wording that we used, I certainly did not write to the hon. Gentleman as he has implied.
This has been a full debate. I have tried to share with the House a very important piece of information—although I am not sure that the hon. Member for Buckingham was even paying attention when I told him that we were providing for discretion on the 10 sq m standard. Perhaps he acknowledged that discretion; certainly some other Opposition Members did. Nevertheless, I hope that that discretion will send a reassuring signal for decent, good quality care home providers—whom we have no intention whatever of hounding out of the business. We need them, and we rely on them. We also want to encourage them to invest in their businesses so that they can be successful.

Mr. Hilton Dawson: Does my hon. Friend accept that what he has just said is


tremendously good news for providers of good-quality residential care who want to remain in business and give excellent care, particularly for older people but also for people with all types of disabilities and difficulties? Do those comments not show that the Government are listening and taking on board the views of people throughout the sector?

9 pm

Mr. Hutton: I am pretty well bound to agree with my hon. Friend on all those points, and I am glad that he feels that way.
We are trying not only to respond to the concerns quite reasonably expressed by the industry, but to meet the legitimate needs of our constituents. It is important that their voices are heard and their interests considered in addressing all the issues. That is the balance that the Government are trying to strike, and I strongly urge my right hon. and hon. Friends to reject this group of amendments, except Government amendment No. 61.

Mr. Hammond: This has been a useful and wide-ranging debate. I am certainly glad that the Minister said that he himself had found it useful.
When I said that I had received a letter from the Minister about door-sweeps and en suite bathrooms, I was working from memory. I do not have the letter with me, and I apologise to him if I misquoted it. However, I am rather more alarmed than I was if he has not ruled out the inclusion of en suite bathrooms, as that once again raises the prospect of home owners who have installed them having to rip them out to meet a future standard.

Mr. Hutton: I am grateful to the hon. Gentleman for giving way on this important point. We are certainly looking to find ways of incorporating en suite bathrooms in the room size standard that we intend to develop.

Mr. Hammond: I take that to mean that the Minister has not written to me to say that he is excluding en suite bathrooms, but that that is what he plans to do.
I was disappointed that the Minister could not accept our amendments Nos. 38 and 39. He read out a great list of titles that could not be used under the Medical Act 1983. However, I did not hear him read out the title "consultant", which is the one causing particular concern. On amendment No. 39, the Minister said that financial viability was an essential attribute for a care home or an establishment, but he did not explain how it would be possible for an establishment in receivership to meet that criterion.
The debate has focused mainly on new clause 4—or rather, it has focused primarily on the standards that will be promulgated, rather than on the new clause itself. The Minister has told us that he is now investigating ways of offering us a flexible response that will allow homes with rooms smaller than 10 sq m to remain in operation. I am grateful to him for sharing that information with the House. He also said that he hoped to be able to give us more detail soon. We shall, of course, wait with bated breath.
New clause 4 itself is about the methodology for preparing and approving the statements of minimum standards, rather than the detail of the standards

themselves. It is clear from this debate that our new clause 4 is an improvement on clause 23, which it would replace, and that it would allow proper parliamentary scrutiny of this very important sphere of legislation. I commend the new clause to my right. hon. and hon. Friends.

Question put, That the clause be read a Second time:—

The House divided: Ayes 159, Noes 299.

Division No. 265]
[9.3 pm


AYES


Ainsworth, Peter (E Surrey)
Gorrie, Donald


Allan, Richard
Gray, James


Amess, David
Green, Damian


Arbuthnot, Rt Hon James
Greenway, John


Ashdown, Rt Hon Paddy
Grieve, Dominic


Atkinson, David (Bour'mth E)
Hamilton, Rt Hon Sir Archie


Atkinson, Peter (Hexham)
Hammond, Philip


Baker, Norman
Hancock, Mike


Baldry, Tony
Hawkins, Nick


Ballard, Jackie
Hayes, John


Beggs, Roy
Heald, Oliver


Beith, Rt Hon A J
Heath, David (Somerton & Frome)


Bell, Martin (Tatton)
Heathcoat-Amory, Rt Hon David


Bercow, John
Hogg, Rt Hon Douglas


Beresford, Sir Paul
Horam, John


Blunt, Crispin
Howard, Rt Hon Michael


Body, Sir Richard
Howarth, Gerald (Aldershot)


Boswell, Tim
Jack, Rt Hon Michael


Bottomley, Peter (Worthing W)
Jackson, Robert (Wantage)


Bottomley, Rt Hon Mrs Virginia
Jenkin, Bernard


Brady, Graham
Key, Robert


Brake, Tom
Laing, Mrs Eleanor


Brand, Dr Peter
Lait, Mrs Jacqui


Brazier, Julian
Lansley, Andrew


Browning, Mrs Angela
Leigh, Edward


Bruce, Ian (S Dorset)
Letwin, Oliver


Bruce, Malcolm (Gordon)
Lidington, David


Burnett, John
Lilley, Rt Hon Peter


Burns, Simon
Livsey, Richard


Burstow, Paul
Lloyd, Rt Hon Sir Peter (Fareham)


Butterfill, John
Llwyd, Elfyn


Campbell, Rt Hon Menzies (NE Fife)
Loughton, Tim



Lyell, Rt Hon Sir Nicholas


Chapman, Sir Sydney (Chipping Barnet)
McIntosh, Miss Anne



Maclean, Rt Hon David


Chope, Christopher
Maclennan, Rt Hon Robert


Clappison, James
McLoughlin, Patrick


Clark, Dr Michael (Rayleigh)
Major, Rt Hon John


Clifton-Brown, Geoffrey
Malins, Humfrey


Collins, Tim
Maples, John


Cotter, Brian
Maude, Rt Hon Francis


Cran, James
Mawhinney, Rt Hon Sir Brian


Davey, Edward (Kingston)
May, Mrs Theresa


Davies, Quentin (Grantham)
Michie, Mrs Ray (Argyll & Bute)


Davis, Rt Hon David (Haltemprice)
Moore, Michael


Day, Stephen
Moss, Malcolm


Dorrell, Rt Hon Stephen
Nicholls, Patrick


Duncan Smith, Iain
O'Brien, Stephen (Eddisbury)


Evans, Nigel
Öpik, Lembit


Faber, David
Ottaway, Richard


Fabricant, Michael
Paice, James


Flight, Howard
Paterson, Owen


Forth, Rt Hon Eric
Pickles, Eric


Foster, Don (Bath)
Prior, David


Fowler, Rt Hon Sir Norman
Randall, John


Fox, Dr Liam
Redwood, Rt Hon John


Fraser, Christopher
Rendel, David


Garnier, Edward
Robathan, Andrew


George, Andrew (St Ives)
Robertson, Laurence


Gibb, Nick
Roe, Mrs Marion (Broxbourne)


Gidley, Sandra
Rowe, Andrew (Faversham)


Gill, Christopher
Ruffley, David


Gorman, Mrs Teresa
Sanders, Adrian






Shephard, Rt Hon Mrs Gillian
Viggers, Peter


Shepherd, Richard
Walter, Robert


Smith, Sir Robert (W Ab'd'ns)
Waterson, Nigel


Spelman, Mrs Caroline
Webb, Steve


Spicer, Sir Michael
Wells, Bowen


Spring, Richard
Whitney, Sir Raymond


Stanley, Rt Hon Sir John
Whittingdale, John


Streeter, Gary
Widdecombe, Rt Hon Miss Ann


Swayne, Desmond
Wilkinson, John


Syms, Robert
Willetts, David


Tapsell, Sir Peter
Wills, Phil


Taylor, John M (Solihull)
Wilshire, David


Taylor, Matthew (Truro)
Winterton, Mrs Ann (Congleton)


Taylor, Sir Teddy
Winterton, Nicholas (Macclesfield)


Thomas, Simon (Ceredigion)
Yeo, Tim


Townend, John
Young, Rt Hon Sir George


Tredinnick, David



Trend, Michael
Tellers for the Ayes:


Tyrie, Andrew
Mr. Keith Simpson and



Mr. Peter Luff.


NOES


Adams, Mrs Irene (Paisley N)
Clarke, Eric (Midlothian)


Ainger, Nick
Clarke, Rt Hon Tom (Coatbridge)


Ainsworth, Robert (Cov'try NE)
Clwyd, Ann


Alexander, Douglas
Coaker, Vernon


Allen, Graham
Coffey, Ms Ann


Anderson, Donald (Swansea E)
Coleman, Iain


Anderson, Janet (Rossendale)
Colman, Tony


Armstrong, Rt Hon Ms Hilary
Connarty, Michael


Ashton, Joe
Cook, Frank (Stockton N)


Atherton, Ms Candy
Cooper, Yvette


Atkins, Charlotte
Corbett, Robin


Austin, John
Corston, Jean


Banks, Tony
Cousins, Jim


Barnes, Harry
Cox, Tom


Barron, Kevin
Cranston, Ross


Bayley, Hugh
Crausby, David


Beckett, Rt Hon Mrs Margaret
Cryer, Mrs Ann (Keighley)


Begg, Miss Anne
Cryer, John (Hornchurch)


Bell, Stuart (Middlesbrough)
Cunningham, Rt Hon Dr Jack (Copeland)


Benn, Hilary (Leeds C)



Bennett, Andrew F
Cunningham, Jim (Cov'try S)


Berry, Roger
Curtis-Thomas, Mrs Claire


Best, Harold
Dalyell, Tam


Betts, Clive
Darvill, Keith


Blackman, Liz
Davey, Valerie (Bristol W)


Blears, Ms Hazel
Davidson, Ian


Blizzard, Bob
Davies, Rt Hon Denzil (Llanelli)


Borrow, David
Davis, Rt Hon Terry (B'ham Hodge H)


Bradley, Keith (Withington)



Bradley, Peter (The Wrekin)
Dawson, Hilton


Bradshaw, Ben
Dean, Mrs Janet


Brinton, Mrs Helen
Denham, John


Brown, Russell (Dumfries)
Dobbin, Jim


Browne, Desmond
Dobson, Rt Hon Frank


Buck, Ms Karen
Donohoe, Brian H


Burden, Richard
Doran, Frank


Butler, Mrs Christine
Dowd, Jim


Caborn, Rt Hon Richard
Drew, David


Campbell, Mrs Anne (C'bridge)
Eagle, Angela (Wallasey)


Campbell, Ronnie (Blyth V)
Eagle, Maria (L'pool Garston)


Campbell-Savours, Dale
Edwards, Huw


Cann, Jamie
Efford, Clive


Caplin, Ivor
Ennis, Jeff


Casale, Roger
Etherington, Bill


Caton, Martin
Field, Rt Hon Frank


Cawsey, Ian
Flynn, Paul


Chapman, Ben (Wirral S)
Follett, Barbara


Chisholm, Malcolm
Foster, Rt Hon Derek


Clapham, Michael
Foster, Michael Jabez (Hastings)


Clark, Rt Hon Dr David (S Shields)
Foster, Michael J (Worcester)


Clark, Dr Lynda (Edinburgh Pentlands)
Foulkes, George



George, Bruce (Walsall S)


Clark, Paul (Gillingham)
Gerrard, Neil


Clarke, Charles (Norwich S)
Gilroy, Mrs Linda





Godsiff, Roger
Mactaggart, Fiona


Goggins, Paul
McWalter, Tony


Golding, Mrs Llin
Mallaber, Judy


Gordon, Mrs Eileen
Marsden, Gordon (Blackpool S)


Griffiths, Jane (Reading E)
Marsden, Paul (Shrewsbury)


Griffiths, Nigel (Edinburgh S)
Marshall, David (Shettleston)


Griffiths, Win (Bridgend)
Marshall-Andrews, Robert


Grocott, Bruce
Martlew, Eric


Gunnell, John
Meacher, Rt Hon Michael


Hall, Mike (Weaver Vale)
Meale, Alan


Hall, Patrick (Bedford)
Merron, Gillian


Hamilton, Fabian (Leeds NE)
Michael, Rt Hon Alun


Hanson, David
Michie, Bill (Shef'ld Heeley)


Harman, Rt Hon Ms Harriet
Milburn, Rt Hon Alan


Heal, Mrs Sylvia
Miller, Andrew


Healey, John
Moffatt, Laura


Hepburn, Stephen
Moonie, Dr Lewis


Heppell, John
Moran, Ms Margaret


Hesford, Stephen
Morgan, Ms Julie (Cardiff N)


Hewitt, Ms Patricia
Morgan, Rhodri (Cardiff W)


Hill, Keith
Morley, Elliot


Hodge, Ms Margaret
Morris, Rt Hon Ms Estelle (B'ham Yardley)


Hood, Jimmy



Hoon, Rt Hon Geoffrey
Mountford, Kali


Hopkins, Kelvin
Mowlam, Rt Hon Marjorie


Hoyle, Lindsay
Mudie, George


Hughes, Ms Beverley (Stretford)
Mullin, Chris


Hughes, Kevin (Doncaster N)
Murphy, Denis (Wansbeck)


Hurst, Alan
Murphy, Jim (Eastwood)


Hutton, John
Murphy, Rt Hon Paul (Torfaen)


Jackson, Helen (Hillsborough)
Norris, Dan


Jamieson, David
O'Brien, Bill (Normanton)


Jenkins, Brian
O'Hara, Eddie


Johnson, Alan (Hull W & Hessle)
Olner, Bill


Johnson, Miss Melanie (Welwyn Hatfield)
O'Neill, Martin



Osborne, Ms Sandra


Jones, Rt Hon Barry (Alyn)
Pearson, Ian


Jones, Ms Jenny (Wolverh'ton SW)
Pendry, Tom



Perham, Ms Linda


Jones, Jon Owen (Cardiff C)
Pickthall, Colin


Jones, Dr Lynne (Selly Oak)
Pike, Peter L


Keeble, Ms Sally
Plaskitt, James


Keen, Alan (Feltham & Heston)
Pollard, Kerry


Keen, Ann (Brentford & Isleworth)
Pond, Chris


Kemp, Fraser
Powell, Sir Raymond


Kennedy, Jane (Wavertree)
Prentice, Gordon (Pendle)


Khabra, Piara S
Prescott, Rt Hon John


Kidney, David
Prosser, Gwyn


Kilfoyle, Peter
Purchase, Ken


King, Andy (Rugby & Kenilworth)
Quinn, Lawrie


Kumar, Dr Ashok
Rapson, Syd


Ladyman, Dr Stephen
Raynsford, Nick


Lammy, David
Reid, Rt Hon Dr John (Hamilton N)


Lawrence, Mrs Jackie
Rogers, Allan


Laxton, Bob
Rooker, Rt Hon Jeff


Lepper, David
Rooney, Terry


Leslie, Christopher
Ross, Ernie (Dundee W)


Levitt, Tom
Rowlands, Ted


Lewis, Ivan (Bury S)
Roy, Frank


Lewis, Terry (Worsley)
Ruane, Chris


Liddell, Rt Hon Mrs Helen
Ruddock, Joan


Linton, Martin
Russell, Ms Christine (Chester)


Lloyd, Tony (Manchester C)
Salter, Martin


Lock, David
Sarwar, Mohammad


Love, Andrew
Sawford, Phil


McAvoy, Thomas
Sedgemore, Brian


McCafferty, Ms Chris
Shaw, Jonathan


Macdonald, Calum
Sheerman, Barry


McDonnell, John
Sheldon, Rt Hon Robert


McFall, John
Shipley, Ms Debra


McGuire, Mrs Anne
Short, Rt Hon Clare


McIsaac, Shona
Simpson, Alan (Nottingham S)


McKenna, Mrs Rosemary
Skinner, Dennis


Mackinlay, Andrew
Smith, Angela (Basildon)


McNamara, Kevin
Smith, Miss Geraldine (Morecambe & Lunesdale)


MacShane, Denis







Smith, Jacqui (Redditch)
Turner, Neil (Wigan)


Smith, John (Glamorgan)
Twigg, Derek (Halton)


Smith, Llew (Blaenau Gwent)
Twigg, Stephen (Enfield)


Soley, Clive
Tynan, Bill


Southworth, Ms Helen
Vis, Dr Rudi


Spellar, John
Ward, Ms Claire


Squire, Ms Rachel
Wareing, Robert N


Steinberg, Gerry
Watts, David


Stewart, Ian (Eccles)
White, Brian


Stinchcombe, Paul
Wicks, Malcolm


Stoate, Dr Howard
Williams, Rt Hon Alan (Swansea W)


Stuart, Ms Gisela



Sutcliffe, Gerry
Williams, Alan W (E Carmarthen)


Taylor, Rt Hon Mrs Ann (Dewsbury)
Winnick, David



Winterton, Ms Rosie (Doncaster C)


Taylor, Ms Dari (Stockton S)
Woodward, Shaun


Taylor, David (NW Leics)
Woolas, Phil


Temple-Morris, Peter
Worthington, Tony


Thomas, Gareth (Clwyd W)
Wray, James


Timms, Stephen
Wright, Anthony D (Gt Yarmouth)


Touhig, Don
Wright, Tony (Cannock)


Trickett, Jon
Wyatt, Derek


Truswell, Paul



Turner, Dennis (Wolverh'ton SE)
Tellers for the Noes:


Turner, Dr Desmond (Kemptown)
Mr. Greg Pope and


Turner, Dr George (NW Norfolk)
Mr. Tony McNulty.

Question accordingly negatived.

New Clause 6

NATIONAL ADOPTION REGISTER

'(1) There shall be established and maintained by the Commission in accordance with this section a list (referred to in this Act as "the National Adoption Register") recording all those persons suitable and willing to undertake the adoption of children in England and Wales.
(2) The Secretary of State shall by regulations make provision for persons to apply to be entered in the National Adoption Register.
(3) The Secretary of State shall by regulations make provisions for criteria to be set by which applications pursuant to the regulations mentioned in (2) above shall be assessed by the Commission.
(4) The regulations in subsection (3) shall provide that any person who a local authority had determined within the period of five years prior to this section coming into force to be fit and proper to undertake adoption of children in England and Wales shall be entered in the National Adoption Register.
(5) The regulations mentioned in (2) shall make provision for a person applying to be listed in the National Adoption Register to appeal against any decision to refuse to so list him.'.[Mrs. Spelman.]

Brought up, and read the First time.

Mrs. Caroline Spelman: I beg to move, That the clause be read a Second time.
We are most grateful that the new clause was included in the revised selection list. It provides us with an ideal opportunity to return to unfinished business that we began in Committee. Since then, important developments have taken place on adoption. The debate will allow us to contrast and compare the aims of our new clause and the Government's proposals. We could not engage in such a debate in Committee, although the Minister gave us heavy hints as to the imminent announcement of a national register.
The new clause provides for an adoption register of parents qualified to adopt, to be held by the National Care Standards Commission, according to nationally established criteria set by the Secretary of State. The provisions on adoption and fostering in this wide-ranging Bill offer us an opportunity to help to amend the law on adoption.
Hon. Members on both sides of the House probably agree that some amendment of the law is necessary. At present, the adoption process is too slow. Families need more support both during the adoption process and in the longer term. Help is needed when an adopted child enters a family, but difficulties can arise much later. Children adopted at the age of five or six might still manifest problems as they enter the troubled teenage years. That period is difficult enough, but it is even harder for young people who have to cope with the disruption to their life of being adopted when they were younger.

Mr. Michael Fabricant: Does my hon. Friend agree that part of the problem is getting adopted in the first place? Children who need to be adopted are available only to potential adoptive parents in a particular county or region. Will the provision of a national adoption register under the new clause ensure matching, throughout England and Wales, of parents who want to adopt and children who are available for adoption?

Mrs. Spelman: My hon. Friend exactly understands one of the main aims of the new clause. It would remove the lottery aspect of the process—in which the family wanting to adopt is constrained by the immediate geographical region and by the variation in eligibility criteria under different local authorities. The new clause would do away with that. At present, adoption is a postcode lottery.
My hon. Friend touched on another important aim of the new clause. It would address the problem that 54,000 children languish in care—[Interruption.]

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I apologise for interrupting the hon. Lady. The conversation below the Gangway should cease. We are holding a debate.

Mrs. Spelman: Thank you, Mr. Deputy Speaker.
We have a poor track record because so many children are in care—54,000. On average, it takes four years for a child to be adopted. It is obviously detrimental for children who have already been damaged by being parted from their birth family to languish in care. Often, they move between various foster parents before they find security and stability in an adoptive family.
The new clause would impress on local authorities the urgent need to draw up plans for the children in their care. Contributing to the national register would increase opportunities for matching, which is restricted by geographical constraints on local authorities. As my hon. Friend the Member for Lichfield (Mr. Fabricant) pointed out, the creation of the national register would provide much better opportunities to obtain a good match.

Mr. Dawson: Does the hon. Lady accept that the views that she has expressed are accepted by hon. Members on both sides of the House? In fact, the proposal for a national register for adoption was included in the adoption consultation paper, which was published last week. As legislation is not required to do what she wants to do, is the new clause necessary? Can we not just accept that the


whole House wants to do what is already in the consultation paper and therefore move on to the important clauses in the Bill?

Mr. Forth: What a silly man.

Mr. Deputy Speaker: Order.

Mrs. Spelman: If consultation papers had such a powerful effect, many more of the Government's good intentions might have had some force in law. It is because we doubt that the Government have enough time to enact a provision that has power and effect that we have sought more urgently to use a Bill that is going through the House to implement the measures for a national register on which we all agree.
There are subtle differences between the Government's proposals in the consultation document for changing the process for adoption and our proposals, even though our aims are the same. It is worth while promoting the new clause to explain those differences.
We believe that the Government's proposal for how and where the register should be held suggests that there will be a lack of independence. The National Care Standards Commission is independent and an ideal body to hold such a national register. We are not satisfied that a register held by some local authorities, which simply draw together their data, is sufficiently independent—and independence will be important.
In the Government's document on adoption, the Prime Minister suggested that a new taskforce should be set up and that it should be called the new adoption and permanency taskforce. However, as I said to the hon. Member for Lancaster and Wyre (Mr. Dawson), how much power and force does a consultative document have? We have also grown sceptical about the power and force of taskforces; they are not always all that they are cracked up to be.
We have a chance with this Bill to make progress and to proceed to implement the ideas that we have in common. I would describe our new clause as a bird in the hand, and a bird in the hand is worth two in the bush. The new clause offers us an opportunity here and now to make the changes.
Two other aspects of the new clause need to be assessed against the Prime Minister's proposals for adoption. Our subsection (4) would recognise that the parents who have already gone through the mill and qualified as adoptive parents on the existing criteria and within the past five years should not have to go through the whole rigmarole again. That is important. People with friends who have had to go through the adoption process know that it is traumatic. It is long drawn out and involves a series of personal and far-reaching interviews. I do not dispute the importance of the interviews, but everyone will agree that it would be hard on people if they had to go through that process all over again.

Dr. Brand: I will be interested to know whether the commission's role under the new clause would purely be to hold a register. Would it also have a role in determining the quality of vetting that took place before prospective adopters could go on to the register?

Mrs. Spelman: The hon. Gentleman's intervention is helpful. He served on the Standing Committee, so he will recall that part of the Bill is devoted to the question of raising the status of social work and the General Social Care Council. As much of what he described as the vetting procedure will be carried out by qualified social care workers, the Bill will have the advantage of bringing about a rise in the status of that profession.
The hon. Gentleman asked specifically how we envisaged the role of the commission. We envisage principally that it would hold the national register, which would draw together all the adoptive parents registered with local authorities throughout Britain. However, if the vetting procedure is to work and be fair for adoptive parents and children, the cornerstone would be the national criteria set by the Secretary of State. Together, those two elements would make the vetting procedure fairer than the present system. The procedure would be carried out by qualified social workers, which would improve the position.
Another important difference between the proposal in our new clause and the consultative proposals in the adoption document concerns the appeals procedure. Proposed subsection (5) of the new clause would create a proper appeals procedure involving the independence of the commission. The Prime Minister's review of proposals to introduce an appeals mechanism for potential adopters is rather unclear about that. We feel strongly that the appeals procedure needs to involve an independent body. Page 5 of the Government document states:
appeals mechanisms for potential adopters should be put in place in all Local Authorities.
We are concerned about having an appeals procedure in a local authority, as potential adoptive parents who have been refused have to make an appeal to the body that refused them. The appeals procedure will be stronger and better if the appeal can be made to an independent body, which is in marked contrast to what is the consultative document.

Mr. Dawson: I am sure that the hon. Lady accepts that adoption is first and foremost a service for children rather than for would-be adopters.

Mrs. Spelman: I do not dispute that it is first and foremost for the children. However, quite a few parents feel that, at the moment, the system does not deal with them altogether fairly, especially when they compare the grounds on which they were rejected by their local authority with the grounds on which their friends may have been accepted in another local authority. That has fundamentally undermined the confidence of potential adopters in an appeals procedure which is limited in all local authorities. There is therefore an important distinction to be made between the Government's proposals and what we would like to achieve in the new clause. I am bound to say that I believe that our proposal is better and would have more support from adoptive parents.
It is important to grasp the nettle, as the Bill creates the opportunity to do something about adoption law. There is no question but that the time is ripe for reform. It is no secret that the previous Government had a draft adoption Bill ready in the last parliamentary Session, but ran out


of time to introduce it. Even if the Government were to introduce legislation in the next parliamentary Session, that might not be a full Session so, to stop history repeating itself, we urge the Government to seize this legislative opportunity to introduce the national register which they said clearly in the consultative document they would like to accomplish.
As the hon. Member for Lancaster and Wyre says, most important are the children. Once displaced from their birth parents, rather like war children, what they most need is security and permanence; they do not need to be moved from pillar to post in the care system. A Department of Health local authority circular, reference No. LAC(98)20, states:
Many local authorities achieve high standards in the provision of children's services… However, recent Social Services Inspectorate reports involving a number of local authorities demonstrate a lack of consistency and co-ordination in England in the overall quality of their adoption services.
We believe that that reveals the need to hold the list at national level and to have nationally set criteria. The information revealed in the Department's own document should lead Health Ministers to draw the same conclusions that we have drawn.
The poor rate of adoption from the care sector reflects the poor level of therapeutic help available to displaced children. By involving the NCSC in a fresh approach to national adoption law, the new clause would create the opportunity to tackle the lack of such care provided during the process, both before and after adoption is complete. There is no doubt that a child who comes into care has already experienced some damage for which therapeutic help is needed; as the child moves into a transitional state—perhaps a foster home—more help may be required; and, as the child enters the adoptive family, yet more help will be needed.
However, there are other groups in the critical triangle who also need such help. Often, the complaint is made that the adopting family receives inadequate support once a child has been adopted. The extremely high failure rate—it is estimated that 20 per cent. of all adoptions break down—must be attributed in part to the lack of therapeutic help provided to the child and the adopting family.

Mr. Julian Brazier: I entirely agree with my hon. Friend's point and I am sure she is right about the causes, but may I point out that 20 per cent. is not an especially high rate of adoption breakdown? The fact that 80 per cent. of adoptions succeed, often with no support of any sort being received and despite the fact that nearly all the children involved have experienced some sort of trauma, demonstrates what a successful institution adoption is.

Mrs. Spelman: By referring to the 20 per cent. breakdown rate, I was not implying that adoption was anything but an excellent solution for many displaced children. However, I hope that the strategic role assigned to the NCSC by the new clause will ensure that the breakdown rate is even lower.
One more piece of the jigsaw could usefully be addressed by the NCSC: providing help to the relinquishing family. They are rather left out of the equation, which leads to the

complex triangle between the child to be adopted, the adopting parents and the relinquishing family becoming unstable. Some adoption breakdowns are rooted in a poor process of relinquishment.

Mr. Dawson: Will the hon. Lady give way?

Mrs. Spelman: I know that the hon. Gentleman cares passionately about the subject, but I should like to make some progress before giving way again.
There is no doubt that one of the advantages of having a national register would be improvement in the matching process. I carried out a little research into authorities local to me to find how practice can vary across the country. That is pertinent to the debate, because it is a problem that the new clause and the national register would address. I examined three local authorities which contrast in terms of size, socio-economic mix and other features. I would like to applaud their efforts, but I am using them to illustrate the extent of variation in practice between local authorities.
I shall take the example of the Coventry adoption service. It allows prospective parents from the city and the rural hinterland of north Warwickshire to adopt children under 12 months from its care. Most people start with a wish to adopt babies, but very few are available. That trend has developed over the past 20 years, with the increasing amount of birth control and support for younger women who choose to manage single handed with a small child. Coventry placed only two babies last year.
For children older than 12 months, the adoption team prefers adoption by parents who live within 50 miles of Coventry. However, adoption outside that radius is permitted, subject to the usual statutory checks by social services or by voluntary agencies such as the National Care Homes Association and Barnardos. Regional adoption is seen as the best option by the local authority because parents living further afield would face practical difficulties in attending Coventry's preparation groups in the run-up to adoption.
Our new clause is designed to address a practical point. There are cost constraints on local authorities, and that is one of the reasons why they tend to focus on a tight radius. The authority is thinking about the costs that will have to be met by prospective adoptive parents, and we should not forget the cost to social workers, who have to travel from their headquarters to interview parents. When those journeys are further afield, that adds significantly to the costs of a social services department. That will need to be addressed if we are to have an optimum matching process that allows a countrywide national register to be held and for the best match to be found.

Mr. Fabricant: Does my hon. Friend agree that speed is sometimes of the essence? Did she see a recent television programme that showed potential adopters, who said that they had been on the register for two years, but that after those two years of waiting they began to question whether they wanted to adopt, and came off the register? Sometimes it is a good thing that people can be matched early. That maximises the number of families that are prepared to adopt.

Mrs. Spelman: My hon. Friend makes an important and sensitive point. A couple may discover that they


cannot have children quite late in life and quite close to the upper age limit, above which they are not able to adopt. The waiting process can be a time of terrible anxiety and uncertainty. Despite initial enthusiasm to adopt, some couples decide in the face of that sort of pressure that they cannot see the thing through to the end. It is hoped that, through the creation of a national register and much improved opportunities for matching and by setting national criteria that are clear and apply throughout the country, the process will become much quicker. The loss of confidence in the process and people giving up on it might become less common occurrences.
I shall give some contrasting examples. Another large local authority near to my constituency is Birmingham. It faces a particular challenge because a quarter of the children in its care are of dual parentage. For that reason, Birmingham focuses particularly on other large conurbations for non-white parents. That is another practical problem that would be overcome by introducing a national register. The capacity for an authority such as Birmingham, with many children of mixed ethnic origin, to find the optimum match would be made more easy.
I contrast that with a small authority, not to criticise that authority but to illustrate some of the problems and some of the reasons for the variation in eligibility criteria that would be resolved by the new clause. My constituency lies in the Solihull local authority. One of its difficulties is the matching process. Its age limit is children under two years of age. That is in contrast to the flanking local authorities. The age limit for parents is not applied in Birmingham and Coventry, but it is 35 in Solihull. Sometimes discretion can rightly be used, but that is Solihull's publicised upper age limit. Therefore, my constituents might well ask themselves why they should be subject to such an age limit when neighbours just over the border in other local authorities are not.
Solihull tries to match children with parents from the same race as a first choice, if necessary placing them with parents outside the borough to achieve its aim. It simply has to because it is so small. That highlights the problem that local authorities are so different in their composition, which has led to the variation in criteria.
9.45 pm
Some local authorities have restrictions on inter-country adoption. I had a constituency case where a couple particularly wanted to adopt from China. They had seen that moving documentary called "The Dying Rooms", which no doubt other hon. Members will have seen, about young Chinese girls left to die because in their society a baby boy is more revered than a baby girl. My constituent's response was to seek with total determination to adopt from China, but they were refused because of restrictions on inter-country adoption.
I am not clear whether that is the key factor that contributes to another rather harsh statistic, but I have my misgivings. It is significant that, if we look at the number of inter-country adoptions by a comparable developed European country with a similar sized population, such as France, we find that there were 3,666 inter-country adoptions last year, compared with 250 in the United Kingdom. That marked contrast must, in part, be explained by some of the criteria set by our local authorities in terms of allowing children to be adopted from certain other countries. I have direct experience of

some restrictions on inter-country adoption in my local authority, which may be contributing to the low rate of inter-country adoption. That reinforces the importance of the need for nationally set criteria.
The new clause is all about making the adoption process easier and more effective, and, at its heart, helping children who languish in care—all to often for far too long for lack of a better process—to find permanency in a family that really wants to adopt them.

Mr. David Tredinnick: It may assist my hon. Friend if I recount my experience of helping a family adopt a Romanian child during the last Parliament when I was much involved with eastern Europe. A child was successfully adopted and the family are very happy, but the parents, who were British nationals, suffered great anguish and heartache because the law was unclear at both ends. They sought to take a child from an orphanage who had little future—we all know about Romanian orphanages—to give that child a life over here, but at one point they were extremely worried that they might be arrested. I shared their considerable heartache and I commend what my hon. Friend is trying to do in the new clause.

Mrs. Spelman: My hon. Friend underlines what we are talking about here, which is that there is a lot of heartache in the adoption process, not only for those who are unsuccessful in adopting, but often for those who succeed, but who find the process a lot more difficult than they thought, and also, often, for the children involved who may never fully recover from the damage caused by being parted from the family that has relinquished them. That is why we must proceed with sensitivity but also with haste, in order to address some of the real problems that could in part be corrected by the new clause.
The new clause would be fairer both to the child and to the parents, given that the state has so obviously failed to fulfil its role as a corporate parent, as is shown by the statistics relating to children in care. We are dealing almost simultaneously with the Children (Leaving Care) Bill, and many of us have served on the Standing Committees considering both these Bills.
Those of us who have served on both Committees are all too aware that 80 per cent. of children leaving care end up homeless, 75 per cent. have no educational qualifications and—this particularly affects me when I think about it and put myself in the girls' shoes—one in seven of the girls leaving care is pregnant or a mother by the age of 16. We cannot hold our heads up high when we think about the role that the state has played as a corporate parent to those children in care.
For all those reasons, we strongly advocate a reform of adoption law so that it is possible for more of those children to leave care and to be adopted in a family—a family that is there not just till the child reaches the age of 16 or 18 or some other fixed limit, but in which, as in any family, a child is for life. That is a strong reason for reforming adoption law.
The Government's proposals do not get to grips with the problem of variation in eligibility. Local authorities such as mine, which have an upper age limit of 35 or 40 for parents, are getting into difficult territory. Women are delaying the age at which they have their first child. There are various social reasons for that—women are looking


for equal employment opportunity, and will often wait for a considerable time before stopping to have a family. They may not realise that their fertility has declined during that time, and they may find, too late, when they have passed the age limits for adoption, that not only can they not conceive, but adoption is no longer open to them.
We strongly contend that there are parents over the age limits who offer good adoption opportunities for children in care, especially for children aged five, six, seven or eight and possibly children in their teens. Not enough consideration is given to the adoption prospects of children in their teenage years. It may well be right for them to be adopted by slightly older parents with more experience of slightly older children.

Mr. Tredinnick: To support of her argument, will my hon. Friend remind the House that medical science is progressing so quickly that ladies can give birth much later in life? There have been newspaper reports recently of women up to the age of 60 giving birth. Does that not make my hon. Friend's case for raising the age limit?

Mrs. Spelman: I should like to be able to agree with my hon. Friend, but the Prime Minister's wife had my sympathy when she gave birth at 45. There is no question that managing a very small baby as one gets older is more difficult. My father, who is almost 92, may have found me quite wearing when I was born.
The child must be the focus. A child coming from care with considerable luggage from the experience of being displaced may benefit from going into a family where the parents are older than 35 or 40, and joining a family in which the other children are of a similar age to the adopted child and the parents are experienced in dealing with children of that age.
In Northern Ireland, there is an active programme to promote the adoption of children in their teenage years and older parents are actively sought. That experience shows that variable and arbitrary criteria can sometimes be obstructive in the adoption process.

Mr. Michael Jabez Foster: Is there not a risk that having the one-size-fits-all option of a national register may result in the individuals to whom the hon. Lady is referring falling outside it? The flexibility that authorities offer at present may give hope to individuals that they may not have if there is only one option.

Mrs. Spelman: Two points arise from that intervention. First, there must be full consultation on the criteria that the Secretary of State will set. We should agree on that as a basic principle. The criteria must also be simple, straightforward and easy to understand. Secondly, we need discretion, such as that exercised by my local authority. Children are individuals; they are not an homogeneous mass. Those who have been in care have individual problems that need specific assessment.
The great thing about a national register and matching process would be that a child with highly specific needs would be far more likely to find the best match from a bigger pool of parents. The Government and the Opposition do not disagree on that, and the Government's consultative document states that they want a national register.
Behind the new clause lies a sense of urgency. We should like to change the law sooner rather than later. In Standing Committee, we heard the Minister's reasons for resisting an amendment—to a different part of the Bill—that was intended to achieve the same as new clause 6. He resisted it first because the Government were about to make an announcement on adoption, as they have since done. He suggested that we should not debate the matter further until the Government's proposals were on the table, after which we could have the fruitful discussion that we are holding now.
Secondly, the Minister argued that the Government could achieve a national register more quickly than would be achieved by an amendment to the Care Standards Bill. He said that the care standards commission would not be constituted until 2002 and that annual returns from local authorities, from which the national register would be drawn up, would not be supplied to it until 2003. I should like to revisit that point. The Government have produced only a consultative document, and I should feel much more confident if the Minister were to say that the Government would introduce a Bill early in the next session.
I am offering a risk-benefit analysis along the lines of my bird-in-the-hand analogy. If the Government should lose the next general election—always a possibility—and given that it is tipped to happen next May, some of the legislative programme announced in the next Queen's Speech would be likely to fall. That is not an unrealistic scenario. To allow the national register to come into existence, debate would have to begin early in the next session.
We are almost splitting hairs in saying that the legislation would come into force in 2001 while the care standards commission—the bird in the hand—will start in 2002. I cannot see why local authorities could not be urged to supply annual returns in time for when the care standards commission opens shop in 2002. Why lose another 12 months? Local authorities have the information, and we simply seek to legislate for that register to be held by an independent body.

Mr. Dawson: I am grateful to the hon. Lady, who has given way three times, but it is not clear from her remarks that anything that she wants to achieve requires legislation.

Mrs. Spelman: rose—

It being Ten o'clock, the debate stood adjourned.

Motion made, and Question put forthwith, pursuant to Standing Order No. 15 (Exempted business),
That, at this day's sitting, the Care Standards Bill [Lords] may be proceeded with, though opposed, until any hour.—[Mr. Jamieson.]

Question agreed to.

As amended in the Standing Committee, again considered.

Question again proposed, That the clause be read a Second time.

Mrs. Spelman: The hon. Member for Lancaster and Wyre has a background in social work and in Committee he contributed many points that informed our work. As relatively new Members, perhaps we can agree that we may not be world experts on the legislative process. However, in my experience consultative documents do


not necessarily receive the force of the law that they need to achieve change such as that which we have described. For that reason, we have tabled the new clause.
I hope that the Minister will give legislative effect to the consultative proposals. The hon. Member for Lancaster and Wyre nods, implying that he has the same hope. Obviously, I would like them to be finessed in the way that I have described, particularly on the point of the appeals procedure, which as proposed in the document is not sufficiently independent to inspire parents with confidence. Indeed, they do not have confidence in the process at present because it is far too in-house.
I look forward to hearing what the Minister has to say. We need to move swiftly and, given that the reform has been a while in gestation, the difference between 2001 and 2002 does not strike me as huge. The important point is whether we are to have a Bill that will bring it into force.

Mr. Ian Bruce: The answer to the hon. Member for Lancaster and Wyre (Mr. Dawson) is simple. If the Minister does not need fresh legislation, it does not matter whether the new clause is included in the Bill. The Secretary of State could implement the reform under several pieces of legislation, but he needs the new clause to make progress if he does not have such a power at present.

Mrs. Spelman: I thank my hon. Friend for that intervention. He has much more experience of the legislative process than I, having been a Member for longer, so he knows exactly how to set out the choice—either/or. However, because this issue is sensitive and important, we do not want to be fobbed off. We need cast iron assurances that the reform will come into effect, as do all the parents who are frustrated by this tardy and haphazard process, which would be so much better were our new clause accepted.

Mr. Brazier: I am grateful for the opportunity to speak to the excellent new clause 6, which was tabled by my hon. Friend the Member for Meriden (Mrs. Spelman). It is set against the background of the positive Government document to which she referred several times, part of which concerns establishing a national register. Our new clause deals with that matter.
At this late hour, the House will be relieved to hear that I shall be brief. However, before dealing quickly with four detailed aspects, I remind hon. Members of the importance of establishing a national register and national standards. There are 54,000 children in care, of whom only slightly more than 2,000 were adopted last year. My hon. Friend gave some horrifying facts about the fate of many of those children. Up to a quarter of the girls become pregnant in care and we hear one sorry story after another. That is not to say that care workers and many devoted and loving foster parents do not do a good job, but in most cases adoption offers the best prospects for children in care because it provides permanence.
The case for a national register is overwhelming, and the best evidence of that is the performance league table for individual local authorities. The top three councils have adoption rates of between 10.5 per cent. and 14 per cent. of the children in their care, but more than 20 councils have rates of less than 1.5 per cent.
I wish to focus on one local authority that would benefit from a national register and some national standards. It happens to be a Labour council, but I do not mention it

in a party political way. I should stress that the second best authority in the country, Middlesbrough, is a Labour council. Islington—left to itself, without a national register or national standards—has a miserable adoption rate of well under 2 per cent. of the children in its care.
The Voice—a very good Afro-Caribbean newspaper—has a lot of good advertisements on adoption, including one recently placed by Islington council. It contained a description of a little boy who needed a two-parent adoptive family who could reflect and promote his ethnic and religious identity as closely as possible. I do not wish to reflect at length on the views of some black members of an adoption group to which I belong, the Adoption Forum, about the good experiences that they had with white parents.
However, for a council to specify that it wants to match the religious identity and racial background of a little boy of less than two years old, and to imply that it is willing to hang on to that child—apparently indefinitely, as the council's poor figures indicate—if it cannot get that match shows how badly we need national standards and a national register.
I do not want to go over the general argument any further, except to say that there can be only a national solution to a situation where local performance is so patchy, varying from a few good councils to a large number that perform so badly.
My hon. Friend the Member for Meriden has mentioned the need for a proper appeals procedure. There is a complicated process, whereby someone who has not been certified by one local authority to get on a list could be considered by another local authority. I prefer the provision in the new clause which makes it clear that there is an independent appeal outside the local authority system.
Independent management of the list is important. It would be quite wrong if the list were to be managed by the local authorities themselves. It would be wrong also if it were to be taken over by the British Agencies for Adoption and Fostering, because although it has an important role to play—given to it by the Government—the list will not be seen as independent by adopters or older children hoping for adoption if it is controlled by the local authorities.
I was pleased to see in the back of the Government's consultation document that a large number of other groups—including the Adoption Forum, Adoption UK, which represents over 3,000 adoptive parents, and the National Organisation for Counselling Adoptees and their Parents, which represents many ex-adopted children—are being consulted. I believe that the association shares that view.
It is critical that the measure is centrally funded. If the national register were set up and local authorities—some of which, such as Kent, are in difficulty with their social services funds—found that it became another service to pay for, there would be a danger that they would not use it. Also, the use of the register ought to be compulsory. I suspect that that is the Government's intention, but it is not clearly stated.
The present position is terrible in many local authority areas. The new clause gives us an opportunity to press the Government to get on with provisions that the preliminary consultation paper suggests already exist in outline, or at least constitute—in part—their intentions. It is


disappointing—all the more reason for the new clause—that the next step will be another consultation paper, or at any rate a White Paper, some time before the end of the year, followed by another consultation period. I urge the Government to act as soon as possible.

Dr. Brand: I congratulate the hon. Member for Meriden (Mrs. Spelman) on making such a strong case for a national register for prospective adoptive parents. I also congratulate her on explaining that we are not just talking about a database for adoptive parents; the register would have to play an active role. However, I hope that the hon. Lady does not assume—as others appeared to—that being on the register would confer entitlement to a child for those who could find one. There is still much hard work to be done to ensure that prospective adoptive parents are suitable to adopt prospective adopted children.

Mr. Fabricant: Of course I agree with the hon. Gentleman about that, but does he agree that—as I said earlier—speed is of the essence? Of course the safeguards of which he speaks should exist, but the new clause would help to speed up the process and to secure a better match, as it were.

Dr. Brand: Undue delay is never useful, but, in the context of adoption, speed is also dangerous. I have a problem with subsection (4) of the new clause, which confers an automatic right if, five years ago, someone said that certain people were suitable adoptive parents.
Things change with time; attitudes change with time. I would be worried about prospective adoptive parents who changed their minds after two years: I would be a bit concerned about how committed they had been to the adoption in the first place.
The hon. Member for Meriden wants an agency that does not fit in with the National Care Standards Commission. The commission is a regulator and an inspector, not a deliverer of services. Adoption is very much an active process. It is not just about regulation; it is about ensuring that things are done properly.

Mrs. Spelman: I think that there are two misunderstandings of what I said. The first concerns the five-year period. Obviously, someone who no longer met the eligibility criteria that had been set nationally would not still be eligible. Secondly, I did not mention an agency.

Dr. Brand: The commission is to set up the national adoption register, and run it. That worries me. I do not believe that the commission, which we discussed during—I think—22 Committee sittings, has ever been seen as a service deliverer. When I say "service deliverer", I mean a deliverer of personal social services, which is what we are talking about in the context of adoption.
I support the hon. Lady's plea for appropriate and speedy action, but let me gently say to her that the problem has not arisen over the past few years. Many of us have discussed it over the past 20 or 30 years. Moreover, the extra complications that the new clause would cause in regard to inter-country adoption pose a significant problem. It would not be possible to develop a national policy to deal with it on the spur of the moment.
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Therefore, I say with great regret that, although we recognise the need to look at a much better package for adoption—mainly to look after the interests of adopted children and the support structures that they and their adoptive parents will need after adoption—I cannot support new clause 6. I do not think that that activity sits happily with—

Mr. Brazier: The hon. Gentleman queries the role of the particular organisation concerned. Does he none the less accept that it is critical that the register be handled by an organisation that is independent of the local authorities themselves?

Dr. Brand: That is a valuable contribution. The hon. Gentleman is right. We are repeating our argument over standards in residential homes. There should be criteria that should not be breached by anyone if they want to become adoptive parents, but then there should be an assessment to see whether those criteria fit the particular child. That creates enormous complexity. We get add-ons to the basic criteria, which will have to be put somewhere on the register to see whether a match can be done.
It is like being a blood donor. A person may be group O, but there may be sub-groups that make that person unsuitable for giving blood to a particular patient. There is complexity in relation to adoption. There is an on-going activity which does not sit happily with the commission as we have discussed it. Therefore, unhappily, neither I nor my colleagues will be able to support the new clause.

Mr. Fabricant: Despite the contribution from the hon. Member for Isle of Wight (Dr. Brand), I cannot help but think there is a degree of unanimity of support for the general thrust—

Dr. Brand: For the objective.

Mr. Fabricant: —for the objective of new clause 6. We must all accept that the present position will not do. The Utting report discussed the regulation of private fostering and was highly critical of the present arrangements. It concluded that private fostering as well as general fostering was an area where children were not being safeguarded properly. It summarised the position by saying that the present arrangements were unworkable.
The tragedy is that there are 54,000 children in care, yet there is a mismatch between the 54,000 children in care, most of whom would be better looked after in foster homes, and the number of people seeking to foster children. [Interruption.] The children are in foster homes, but they would like to be adopted by private families; I thank hon. Members for correcting me. My point is that there is a mismatch between the number of children who are in foster homes—in care—who should be adopted and the number of private families. A private family can offer a better environment for bringing up children. Again, I do not believe that there is any argument about that in the House.
Just as I think that all parties in the House would say that, where there is a mismatch between the number of people who are seeking a job and the availability of jobs, there should be mobility of labour, so I believe that there should be a mobility of children. It is wrong that there should be the mismatch of which I have spoken.
As my hon. Friend the Member for Meriden (Mrs. Spelman) pointed out, there is a huge variation between those areas where potential parents cannot be aged over 35 and those where the age limit is 40. That is not the only criterion that is different. In many different areas, many different criteria are used.
The hon. Member for Lancaster and Wyre (Mr. Dawson) said that he supported the general motive of the new clause, yet he asked what the point was of adding it to the Bill because it is in the Prime Minister's review of adoption. However, as my hon. Friend the Member for Meriden said, good intentions are not enough. Indeed, as my hon. Friend the Member for South Dorset (Mr. Bruce) asked, if the Government believe that a national register is a good idea in principle, why do they object to new clause 6?
In an intervention on my hon. Friend the Member for Meriden, I made the point that there have been cases in which, after two or three years of waiting on a list, prospective parents have changed their minds about adopting. They have simply been discouraged by authorities saying, "You may or may not be suitable to adopt." People have second thoughts about adopting, as was shown in a recent television programme. Like other hon. Members, I have also seen such cases in my own constituency.

Mr. Ian Bruce: The Government rightly received an enormous amount of good publicity for their announcement that they would establish a national register, and we thought that that announcement was reality rather than spin. Is it not extraordinary that, now that a clause to do exactly that is being presented to them, they say, "No, we don't want to do it yet"? Are they not simply spinning, rather than getting on and doing something?

Mr. Fabricant: As I should like to think of this as a harmonious, cross-party debate, I shall not enter the debate on spin. Nevertheless, I do have to ask why Ministers are not keen to accept new clause 6. Undoubtedly, the Minister will eventually give us those reasons. However, even if the Government are not happy with the details of new clause 6, surely the new clause's principle could be included in the Bill. There is a vacuum in any such provision, resulting in 54,000 children being left in care.
My hon. Friend the Member for Meriden described the position of the United Kingdom in relation to other countries on the inter-country movement of children. As we heard, only about 250 children from abroad have been adopted in the United Kingdom. My hon. Friend the Member for Bosworth (Mr. Tredinnick) described such a case in his own constituency.
I have a similar case in my constituency, involving a family in Burntwood who want to adopt a young child from Romania. They are having great problems in adopting the child not only because of the different adoption criteria of different local authorities, but because the immigration authorities have said that the child has overstayed his leave to remain in the United Kingdom, thereby forcing the family to race against the clock in their attempt to adopt. The child may be sent back to Romania—not to go into care, but to be returned to the home, with quite dreadful conditions, from which he was only recently extricated.
As my hon. Friend the Member for Meriden said, a national register has two advantages, the first of which would be central funding. Surely our duty of care to children in care applies equally to all children who will affected by the Bill—in this case, to children in England and Wales. There should not be regional variations in the exercise of that duty, and a centrally funded national register would ensure that each area has equal resources.
The second advantage would be central standards. I must confess that I had some sympathy with the hon. Member for Isle of Wight when he expressed reservations about new clause 6(4). He argued that people who had been included on an adoption register up to five years previously might no longer be suitable to adopt. I suggest to my hon. Friend the Member for Meriden that if new clause 6 is accepted, one of the tasks for the commission that maintains the national register would be very quickly to inspect the families hoping to adopt who had been put on a local authority register more than two or three years previously. Those families circumstances may have changed in the intervening period.
At present there is too much variation. There are about 80 independent fostering agencies and about 35 voluntary adoption agencies with a total of 60 branches. The situation is dire. There are 54,000 children in care, and that is 54,000 children too many. If there were 54,000 children in care with hardly anyone seeking to adopt, at least the position would be understandable, but that is not the case. There are more than 10,000 families seeking to adopt children. If new clause 6 means that some, if not all, of those 54,000 children in care can be adopted into a stable family environment, it should be adopted by the House tonight.

Mr. Collins: I was struck by the comments of the hon. Member for Isle of Wight (Dr. Brand), who produced a number of superficially cogent reasons why he felt that although the objective was shared by all hon. Members, new clause 6 was not the best means of securing it. In many respects the debate so far has established that with adoption, the best is often the enemy of the good.
Although the hon. Gentleman may be right that to say at some time in the future there might be a superior legislative vehicle, this is the only one available in the current parliamentary Session; it may well be the only legislative vehicle available before the next general election. So, despite the fact that the hon. Gentleman's arguments seem to have some force, if the alternative is to wait not just months, but possibly years for any legislation on the matter, accepting new clause 6, possibly with an undertaking to amend or improve it in another place, would be a sensible means of making progress.
The same argument applies to the important points made by the hon. Member for Lancaster and Wyre (Mr. Dawson), who acknowledged that the new clause embodied an important objective, but asked why we had to have this debate. It is important to recognise that we are dealing with a subject that should be properly debated and fully discussed.
In that context, I would like to put on record something on which hon. Members on both sides of the House are united, but which has not been properly expressed tonight. Although there is a general preference and presumption in favour of adoption over local authority care, that does not mean that any right hon. or hon. Member is belittling


the enormous contribution made by people who work in local authority care, many of whom do an immensely good job, work extremely hard and should be rewarded and applauded for the sacrifices that they make. However tonight's debate concludes, many children—particularly those who are in care—will be looked after by local authority care workers for a long time. In the overwhelming majority of cases, they will be looked after extremely well. It is important that that should be put on record in the overall context of adoption.

Mr. Dawson: I agree with everything that the hon. Gentleman has said. Does he accept that a large proportion of children and young people in care still have good relationships with their natural families and often return to them shortly after being taken into care? Therefore, a large proportion of young people in care are not available for adoption, which in any case would not be appropriate for them.

Mr. Collins: The hon. Gentleman makes an important point. It is essential to recognise that although there is cross-party agreement that adoption should be made easier and more widespread, there will always be a continuing role for local authority care, for the reasons that the hon. Gentleman mentioned, among others.
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The hon. Gentleman spoke about cases in which adoption is rarely, if ever, the best outcome. However, it is important to stress that in most other cases adoption offers the best prospect of giving children permanent and secure homes in a genuine family atmosphere. Moreover, there is a long-term aspect. Children's need for emotional, financial or practical support does not end at 16 or 18. It may be easier for them to receive that from adoptive parents than from local authorities, which, given the calls on resources, tend to concentrate their efforts on younger children.
Most children would benefit if a national adoption register, as provided for in new clause 6, were established. As the hon. Gentleman said, the child's interests must come first. However, there is often no conflict between the interests of the child and those potential adoptive parents. Both sides are seeking to create a loving family atmosphere from which all involved can benefit. I know that the hon. Gentleman did not mean to imply it, but it is important to accept that there is not necessarily a conflict of interests in such cases.
The House seems to agree about the principle of a national adoption register. What should be its characteristics? I agree with the hon. Member for Isle of Wight (Dr. Brand) that such a register has taken a long time to arrive, having been promised by Governments of all political colours. I hope that we will move forward with it, and I welcome the conclusions in the consultative paper that suggest that the Government are persuaded of the need for the register.
The register must set out clear standards that are openly arrived at and clearly understood. Implicit within new clause 6 is the question of the extent to which criteria for inclusion in the register are widely explained, so that people understand them. They should be published,

on the internet and elsewhere, so that people will be able to understand why they have or have not been included. Understanding is limited at present by the different approaches adopted by local authorities.
New clause 6 offers potential adoptive parents two possible routes by which they may get on to a register. Under new clause 6(4), they can apply to their local authority.

Mr. Fabricant: Does my hon. Friend share my concern—which I am ashamed to say was also expressed by the hon. Member for Isle of Wight (Dr. Brand)—that people considered suitable by a local authority five years ago may not now be considered suitable?

Mr. Collins: I take the point, which was made originally by the hon. Member for Isle of Wight. I understand why some time period should be specified, and I can see why five years was chosen, although I am not sure that that is the right length of time. However, a much shorter period would require quite a lot of bureaucracy, as what would amount to a rolling review would have to be instituted.
In addition, a proper notification mechanism would be needed for people on the register who are no longer considered suitable. The reasons for such a change may be more or less dramatic, but we need a clear procedure by which the local authority, or other public body that acquired the relevant information, could notify the holders of the national register and get the person concerned removed as fast as possible.
The time involved would have to be more than a year, but I agree with my hon. Friend the Member for Lichfield (Mr. Fabricant) that five years may not be ideal. However, as I said earlier, the best can sometimes be the enemy of the good. Even though I would not die in the trench for every word of new clause 6, I would rather have it than not have any such provision at all.
I was talking earlier about the two routes by which a potential adoptive parent could register interest and be approved. The first is the existing route through the local authority. The second, which is set out under the procedures covered by subsections (2) and (3) of new clause 6, would allow people to apply directly to the holders of the national adoption register for inclusion there and then. Potential adoptive parents who, for whatever reason—perhaps no more than a simple personality clash—feel that they have incurred the displeasure of their local authority, or rather, the small number of decision makers in their local authority, and who, for good reasons or ill, have lost confidence in their local authority, could have a second bite of the cherry. This should not be a way of enabling clearly unsuitable candidates to exploit a loophole and get on to a register. However, borderline candidates, or those who had a problem at the start of their application process, would know more clearly the reason for the decision that was reached, even if the final answer was still no. They would know that their case had been properly aired by people who were not headquartered in their local area.
Proposed subsection (5) of new clause 6 would allow appeals to be made. In her excellent speech introducing the new clause, my hon. Friend the Member for Meriden (Mrs. Spelman) explained why it would be desirable to have an appeal mechanism independent of the local


authorities. She explained that that is a slightly different approach from that set out by the Government in their consultation paper, because it would involve something more than a simple aggregate of local authorities across England and Wales. That is an important point, which I hope that the Minister will address in his remarks.
Whether the body holding the register should be, as the Government propose, an aggregate of the local authorities, or whether it should be, as is proposed in new clause 6, the National Care Standards Commission or another body, the appeals mechanism must be seen to be independent of the holding body. It would not be in the spirit of new clause 6 if the appeals mechanism set up by the National Care Standards Commission to allow its decisions to be appealed against, were part of the commission. "Independent" must mean independent of the commission as well as of local authorities.
The objective of new clause 6 is very important. It is clear from what has been said, and from the many powerful examples cited by my hon. Friends and others, that, unfortunately, we have a postcode lottery. Potential adoptive parents and children are treated very differently according to where they are resident at any given time. That is difficult to justify, and although inherent in any system of local discretion and local authority control is the possibility of differentiation, the differences described in the debate are on such a scale as to be difficult to justify. The principle of a national register must be right, and it must be right that we put such a register on the statute book as soon as possible.
I was intrigued by the earlier remarks of the hon. Member for Lancaster and Wyre. He said that he believed that it would be possible for progress to be made on the Government's report without legislation. He seemed to be saying that he thought that it would be possible for a register to be set up without any statutory framework. The hon. Gentleman is nodding vigorously, so I must be paraphrasing his remarks accurately. I should be very interested to hear whether the Minister confirms that, and if so, whether the Government intend to proceed with establishing a register in advance of legislation. If they intend to do so, would such a register be made statutory sooner rather than later, or do they foresee an indefinite period during which the register would operate with no statutory backing? That could raise difficulties when controversial decisions—in a minority of cases, I hope—were appealed against in the courts. If the register had no statutory backing, the Government would be creating a rod for their own back.

Mr. Fabricant: Does my hon. Friend agree that if such a register had no statutory backing, local authorities would have no statutory obligation to provide information for it? Just as there is a patchwork of criteria across local authorities for people who are allowed to adopt, so there might be differences in the degree of co-operation authorities would be prepared to offer with such a register if it had no statutory backing.

Mr. Collins: I take my hon. Friend's point. The vast majority of local authorities would want to co-operate, whatever their political control. However, we are dealing with a disparate range of local authorities and, without statutory backing, there is less chance of receiving 100 per cent. co-operation from 100 per cent. of them, if only because local authority officers—who, as we know

from our constituency work, are often greatly burdened with responsibilities and the other requirements that are pressed on them—tell us that they are barely able to keep up with their statutory duties.
Those officers certainly would not be able to undertake duties that were, in effect, voluntary. Some of them might downgrade their co-operation with the register—although not in a deliberate attempt at sabotage. They would tell the elected councillors that they must carry out Parliament's statutory requirements. Only when they had done that would they be able to undertake other activities. Those activities might well be desirable, but they would not have the time or resources to undertake them.
Early statutory backing for a national register is important. The new clause offers an appropriate mechanism for debating it. I hope that the Government will look with favour on the provision—ideally this evening. Ministers listened constructively when we debated the measure in Committee, so I hope that in that spirit, they might reflect on the new clause and offer us some thoughts on it at a later stage.
It is important to acknowledge that if we place the welfare of the child at the centre of our objectives—as we should—the best means to advance that welfare will be to ensure that the child, or those who make decisions on the child's behalf, have access to the widest possible pool of potential adoptive parents. That cannot happen when the pool in any given area is confined by the local authority. Only if it is national can the pool be as large as it should. That is why I hope that, whatever the fate of the new clause, we move as swiftly as possible towards the establishment of a national adoption register.

Mr. Ian Bruce: I speak to the new clause from two aspects of my personal experience. First, I am the joint chairman of the all-party group on street children. I see that one of the other joint chairmen, the hon. Member for Newcastle-under-Lyme (Mrs. Golding), is leaving the Chamber. She is probably going for a rest. Secondly, my wife and I were short-term foster parents for several years. Both those experiences are relevant to our discussion of the new clause.
Whenever the all-party group makes overseas visits in connection with its work on street children, we meet British people who have taken an enormous amount of time and trouble to adopt children from the country in question—however difficult it is to reach. When we ask them why they have done so, the answer always comes back to the fact that, in the UK, they were barred for being too old or the wrong colour or whatever. There is an enormous latent demand from parents who want to adopt children.
We often say that the primary purpose of any adoption must be the benefit of the child—that is a given. However, if an adoption is not to the benefit of the parents as well, there cannot be a proper match. No childless couple or individual adopts a child other than to fulfil a need. There is a natural human desire to have children and to bring them up. My wife and I have been lucky enough to have four children, and bringing them up—however well or badly we have done it—is our greatest achievement. We must take account of the couples who want to adopt children, because they are likely to provide the best homes for them.
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I wish to describe the experience that my wife and I


had when we decided we wanted to become short-term foster parents. At the time when my first son was born, we lived in Scotland. My wife had given up work and we thought that we could do short-term fostering in our house while we brought up our young children. We therefore made inquiries but, after six months, a decision had still not be made as to whether we were a suitable couple to become short-term foster parents.
We moved, so we started the process again in West Yorkshire when that was a county authority dealing with fostering. We met wonderful people who were clearly concerned about children, but we never met anyone who seemed to have any common sense. I am grateful that our social worker friend, the hon. Member for Lancaster and Wyre (Mr. Dawson), is smiling at that. We had meetings, but then everything would go quiet for three months. We would ring up to find out what was happening about the fostering and someone would say, "I've been terribly busy, so I'll come and see you again." We would have another meeting and another three months would go by.
Social workers investigated my work and our family. The strange thing is that in the time they took to decide whether we were a suitable couple—it was more than a year—my wife became pregnant with our second child and I lost my job. By the time our background had been investigated and the social workers had decided we were suitable, our circumstances had completely changed. The process was daft.
We should not accept people who walk in off the street as short-term foster parents, but we must get on with the process of carrying out the investigations. One of the problems is that the social workers who are responsible for the children with difficulties who might be suitable for short or long-term fostering and adoption—that is sometimes the ideal route—are so swamped with social problems that they have no time to consider whether the right type of parents are available to adopt the children. Even more important, areas with social problems are not likely to be the areas where the mass of the potential adoptive parents live. There is a mismatch between the areas affected by social problems and the areas where the more stable families who are better able to look after children live.
That mismatch takes place between different local authorities, and a national register would at least start to address that problem. If we had more time, the new clause could have gone much further in describing how we could establish the register. However, such a register might kick-start the process so that it works properly.
Another problem in the adoption process is the fault of Parliament. Every time a child is abused in the system—unfortunately, an awful lot of that abuse has happened in children's homes—we pile on social workers rules and regulations that make them so incredibly scared and careful that they cannot take a step without making yet another check. They cannot lose their job for refusing to approve someone as an adoptive parent, but they might be criticised in a judicial inquiry set up by this place if they make a mistake.
We know that if we leave children in children's homes, and do not give them permanent families, they are at enormous risk. I do not know how many children have been abused by their adoptive parents, but I suspect that

the number is tiny: I cannot recollect a case that has been in all the newspapers. We would remember such a case and comment on the fact that adopted children were being abused. That does not seem to be happening.

Mr. Brazier: The councils with the worst records on abuse in children's homes and among foster carers—Lambeth council has been the source of recent, well-publicised examples of the latter—are the same councils that are exceptionally poor at putting children out for adoption. My hon. Friend is therefore entirely right to say that the endless checking of politically correct minutiae does not keep abuse at bay.

Mr. Bruce: I am grateful to my hon. Friend, who is much more knowledgeable about such cases than I am.
This may sound too political, but when the Government want a good headline, they announce that they will do something about this problem. I made speeches similar to this when the Conservative party was in power because I wanted the system to work better. The Government could do something rather than just talking about it, and they could benefit their political careers—if that is a requirement for getting something done, that is fine. However, it is not acceptable that the Government should brush the new clause under the carpet and say that this would be a good thing to put in their manifesto and act on in the next Parliament; action should be taken now. Let us not have any delay.

Sir Nicholas Lyell: I am glad to have the opportunity to make a short contribution to the debate. I apologise to my hon. Friend the Member for Meriden (Mrs. Spelman) and to the House for the fact that I was unable to hear the whole of her speech. I strongly support new clause 6, and this is a good opportunity for the House to consider it. The House is particularly lucky to have the Minister of State to reply to the debate, because he has been at the forefront of the Government's efforts to introduce and speed up change in adoption. He has chaired the performance and innovation unit's steering committee, which has looked into the matter.
Those of us who believe that the new clause should have a fair wind find a good deal of support from a pretty powerful source because page 4 of the adoption report contains an introduction by the Prime Minister. He says:
It is clear from the PIU report that there are some things we can get on with quickly. Over the next few months we will therefore: develop and implement proposals for a National Adoption Register…
The question is how one implements that, and my hon. Friend the Member for Meriden is absolutely right to table the new clause to find out whether the policy can be implemented in this Bill.
I think that Members on both sides of the House agree that the changes and welcome innovations in adoption law have been a long time coming. We know that there is pressure on legislative time in any Parliament, but it is exceptionally heavy in the current Parliament—the Government have packed this Session with Bills. I say that not to be controversial but to emphasise that when there is a parliamentary vehicle available for a purpose, it should not lightly be set aside.
We have heard what the Prime Minister has said on the subject and we know that it will be considered over the next few months. The consultation document issued this


month allows for a proper consultation period—not one that is unduly short, as others have been, but one lasting three months, with receipt of consultation responses expected by 6 October. I doubt that the House will return after the long recess before that date; in addition, those who are expert in the subject will know what to expect in the way of responses to the consultation and will have time to assimilate them.
With all that in mind, I would argue that it is not impractical, in parliamentary terms, to include in the Bill a statutory framework for a national adoption register; nor would it be inconsistent with the Government's manner of legislating—which we sometimes deplore, but which might be appropriate in this case—if the new clause were accepted as the vehicle and, provided that the principles were set down in the primary legislation, modified to some extent to enable the details of a national adoption register to be dealt with in secondary legislation.
I hope that I have established that there are perfectly sensible reasons to accept the new clause now, before the Bill is returned to the other place in the normal course of events. The Bill came from the other place on 5 April without the issues addressed in new clause 6 having been debated, because it was only in February that the Prime Minister had made his—welcome—announcement of a personal initiative to take a grip on adoption. The Prime Minister has been subject to great pressure in recent weeks—rightly so, most Conservatives would think—but on this subject we can find common ground with him. He has spoken a lot of good sense and we are glad to lend our constructive support to his efforts.

Mr. Bruce: My right hon. and learned Friend says that the new clause, if accepted, could subsequently be altered in the other place. I note that it begins by saying that a register:
shall be established
but, if the Government are reluctant, they could modify it in the Lords and replace "shall" with "may". That would give the Government a permissive power, but not force them to act.

Sir Nicholas Lyell: My hon. Friend makes a fair point. I have suggested that the modification might be achieved through secondary legislation, but the method and timing would be a matter for the Government of the day. The fact is that our purpose could be achieved legislatively without difficulty.
Having dealt with the framework, I turn to the substance of the matter and the argument in favour of establishing a national register. The whole House would agree that to set out to be approved as a prospective adoptive parent is a daunting pilgrimage. Two features of adoption stick out starkly. The demand for children to adopt where those children are very young, or not so young but have been taken into care, substantially exceeds the supply of children to be adopted. By contrast, although, happily, there is a significant pool of parents who are willing to adopt children from care—many are parents who have fostered children, like my hon. Friend the Member for South Dorset (Mr. Bruce) has done, and are willing to move on to adoption—that pool could valuably be increased. A national adoption register would provide a good method of encouraging people to consider adopting from children in care.
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Let us not exaggerate the number of children in care who are available to be adopted. The consultation document shows that there were some 55,300 children in care in 1998, but obviously by no means all of those would be candidates for adoption—the figure would probably be 1,000 or 2,000. I might be being unduly pessimistic, but I think that about 2,000 children from that pool of 55,000 have been adopted over the years. Perhaps the Minister can tell us over how many years how many children have been adopted from the pool of children in care.
Another interesting fact in the consultative report is that the United States is a little bit ahead of us in this area. Britain can be proud of being second in the world in the proportion of children adopted from the pool of children in care. We achieve some 4 per cent. The United States achieves some 7 per cent.—about 1,500 children. I am not sure if it is 1,500 children a year or at any one time—no doubt the Minister will elucidate—but it is getting on for double the number of children.
Also striking is the average age of children who are adopted in the United States. In Britain, the average age is one year and two months. In the United States—this is highly significant for children in care—the mean age is six years and nine months. In other words, there are pools of parents in the United States who are willing to take on the tremendously important, and in a way significantly more difficult, role of adopting such children.
The process of encouraging that must be taken gently over a number of years, but the national register will provide a sensible way of getting started on that desirable route. It will provide parents who may hitherto have been daunted with an opportunity to talk through the problems with professionals. The fact that it is done with professionals on a national basis, and in circumstances where an immediate pressing desire for adoption is rather less acute than in some other cases, will enable it to be done well. There will be an opportunity for both the potential parents and the authorities to reflect, for the potential parents to be assessed, for a conclusion to be reached, and, hopefully, for a significant number to be included in the register.
Those who are included in the register will be able to find a suitable child to adopt whom they may well have fostered on an interim basis in the meantime, providing a better life for a small but none the less significant proportion of those 55,000 children who are in care. Of course, one hopes that a significant proportion of those children will go back to their own parents in due course, but there are many who do not have that opportunity. The national register will enable many hundreds, perhaps a few thousand, to find a happier home, and that is something on which all hon. Members will agree.

Mr. Hutton: I thank all hon. Members who have taken part in the debate. On the occasions when we can agree on a sensible way forward, we should not be shy in saying so, and the national adoption register commands a substantial measure of support in the House as a sensible way in which to proceed. The right hon. and learned Member for North-East Bedfordshire (Sir N. Lyell), whom I thank for his kind comments about me, displayed the mastery of a brief which we lawyers like to display.


As a former Attorney-General, he showed himself in his finest colours tonight in his mastery of the intricacies of the performance and innovation unit report.
I shall try to confine my remarks to the substance of the new clause, which calls for the establishment of a national adoption register under the auspices of the National Care Standards Commission. I shall explain to the House the Government's commitment to establishing a national adoption register, as several hon. Members have asked me to do in detail. I shall also explain why new clause 6 is probably not the most sensible way to go about it.
Having undertaken the review and received the recommendations of the PIU, which prepared the report, the Government decided to take a number of steps. We are committed to the establishment of a national adoption register for England and Wales. Let me make it clear to Opposition Members who raised the issue that, as stated in the PIU report, we intend to tender for the operation of the national adoption register. Later this year, we will invite applications to operate the register. We hope to get the register up and running some time next year.
The PIU report raises the question whether we need any legislative underpinning for the national adoption register. We are consulting on that. If legislation is required to establish the register, we will include those proposals in the legislation that we plan for next year. However, it is desirable that we should go ahead now with the establishment of a national adoption register, and that is what we intend to do.
The hon. Member for Westmorland and Lonsdale (Mr. Collins) asked how we would do that. We have an opportunity to use the powers in section 7 of the Local Authority Social Services Act 1970 to issue statutory guidance to local authorities, if that is the mechanism for making sure that the register remains an accurate register of children and approved prospective adopters.
The Government are going ahead with establishing the register. We want to do it quickly, and we are grateful for the support expressed by hon. Members for the register.
What is wrong with new clause 6? Why should we not incorporate it in the Bill? There are three or four problems with the new clause. First, it deals only with local authority approved adoptive parents. It is not clear how the register proposed by the hon. Member for Meriden (Mrs. Spelman) would work in relation to adopters approved by voluntary adoption agencies. Many hon. Members expressed their support in principle for the work that VAAs do. The new clause would exclude adoptive parents who had been approved by VAAs. That is not a sensible way forward.
Secondly, and more problematically, the new clause does not provide for the inclusion of children available for adoption. If the purpose of the register is to match prospective adoptive parents with children, the hon. Lady's solution clearly will not achieve that, because there is no provision in the new clause for children to be recorded on the database that she wants the National Care Standards Commission to operate.
If those problems were not sufficient to persuade the House not to support the new clause, the other difficulty—which is the same difficulty that we encountered when the hon. Lady moved a similar new clause in the Standing

Committee—is that the establishment of the commission will take about two years. We intend to establish the commission from next April. Presumably, the national adoption register would come into operation some time after that.
Given the support that I have heard tonight for such a register, I do not believe that many hon. Members, having studied the proposals moved by the hon. Lady, would want us to hang around for that length of time before we establish the register. We should get on and do it as soon as possible. That is what we shall do. We believe that we can do that and operate the register using the powers that we have. It is essentially an administrative arrangement. If we need to underpin it with primary legislation, we will do so next year. Despite the positive and welcome comments in support of the register that we heard tonight—

Mr. Ian Bruce: Will the Minister give way?

Mr. Hutton: I am not giving way. It is probably best that the House gives its blessing to the Government's proposals and that we get on with establishing the register. If we need to return to the matter in primary legislation, we will do that next year.

Mrs. Spelman: When we prepared the new clause, the Government had not made their proposals. We have learned a great deal more since then. We accept what the Minister says about the Government introducing legislation early in the next Session. That is entirely in the spirit of consensus in which the debate on the new clause has been conducted. If the Government introduce the legislation early in the legislative programme next year, we will certainly support it—[Interruption.] I hope that the Minister is listening to the kind offer that I am making—as we are all agreed that we want to establish a national adoption register. When we make nice offers, it is important that they should be received.
The point about legislative underpinning is an important one. I am grateful to my right hon. and learned Friend the Member for North-East Bedfordshire (Sir N. Lyell) for making it. I should hate it if we looked back in a year's time to realise that we had missed an opportunity. We accept that section 7 of the Local Government Bill may provide powers to make local authorities make the changes happen.
Having made those points, and given that we accept the Minister's points about inadequacies in our drafting—we do not have the resources at our disposal that the Government have—we will withdraw the new clause and look forward to seeing a legislative proposal early in the next session. I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.

New Clause 7

ALTERNATIVE AND COMPLEMENTARY THERAPIES

'.—(1) A person is an alternative or complementary therapist if he is providing or offering for gain or reward services purporting or claiming to alleviate, cure, suppress or improve any condition which is customarily addressed by services of a type provided by health authorities, special health authorities, National Health Service trusts, primary care trusts or by local authorities in the exercise of their social services functions, and who is not required to be registered under section 11 or section 42.

(2) The Commission shall maintain a register of alternative or complementary therapists.

(3) The Secretary of State shall provide by regulations the method by which—

(a) applications for registration shall be made; and
(b) applications for registration shall be determined.

(4) The Secretary of State may by regulations make such provision as he deems necessary to protect the public in respect of—

(a) the description of the services provided by the alternative or complementary therapist;
(b) the claims that may be made in respect of those services;
(c) the techniques which may or (as the case may be) may not be employed in delivery of such services; and
(d) any other matters relating to such services as the Secretary of State may specify.'.—[Mrs. Spelman.]

Brought up, and read the First time.

Mrs. Spelman: I beg to move, That the clause be read a Second time.
One of the most intriguing things about this wide-ranging Bill is the opportunities that it provides for mini-debates on quite different subjects. We shall see the advantages of that this evening as Members have the chance to discuss their particular interests, as in the previous debate on adoption and in this one on alternative and complementary therapies.
In Committee, we tabled an amendment on alternative and complementary therapies. The Under-Secretary resisted it. First, she said, complementary and alternative medicine is, by definition, evolving and cannot be clearly defined. Secondly, she said that it was neither practical nor justifiable to regulate an ill-defined sector. Having read and considered Hansard, I have moved the new clause because I believe that those arguments are not sufficiently robust.
In Committee, the Minister said:
Services that were considered outlandish several years ago are now almost considered to be part of conventional health care.—[Official Report, Standing Committee G, 6 June 2000; c. 81.]
Within the huge bracket of alternative and complementary medicine, some therapies have been around for a very long time. Acupuncture has existed for at least 2,000 years, but, at the other end of the spectrum, new therapies such as reflexology were probably unheard of by most people as recently as 10 years ago.
Therapies quickly become established. Alternative medicine is growing rapidly. The medical care research unit at Sheffield university estimates that 40 per cent. of general practitioners provide access to some sort of complementary medicine. Already, there is a close interleaving between traditional and complementary medicine. Acupuncture, which I have already said is one of the oldest complementary therapies, is provided by 73 per cent. of primary care groups. Osteopathy, which is

also well established, is provided by 43 per cent., homeopathy by 38 per cent. and chiropractic—which I have had good reason to use—by 23 per cent.
Those therapies are well established and widely used. Members of the public will often consider alternative and complementary therapies when they feel that they have made no progress down the conventional medical route and are prepared to pay their own money to solve the problem or salve the pain that they are experiencing. We all have good anecdotal evidence from friends and relations of success with complementary and alternative medicines.
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The Bill offers an opportunity to help to provide a regulatory framework for complementary medicine, some branches of which are long established. There has been no over-arching regulatory framework because different techniques are used and different training courses apply. For example, chiropractors go through undergraduate training to gain a BSc honours degree, but I understand that, in the eyes of those who practise acupuncture, a 24-hour training course will suffice for a certificate of basic competence.
However, the diversity of qualifications should not deter us from drawing alternative and complementary therapies into the Bill. Social care is to be regulated and a distinction made between social care workers and social care assistants who have different qualifications. Therefore, within the logic and principle of the Bill, it is possible to regulate care workers with different qualifications and the different titles resulting from them. I see no logical objection to trying to regulate alternative and complementary medicine.
The availability of alternative and complementary therapies is increasing and people are becoming better informed about fresh approaches to established medical conditions. They avidly read the features pages of the broadsheet newspapers and, if conventional medicine has found no solution, often present their GPs with new findings on long-standing problems. A large number of new practitioners have set up in response to increasing demand. Therefore, it seems logical to provide through legislation adequate protection for the public and regulation that recognises the importance and status of the complementary therapies.
In Committee, my hon. Friend the Member for Runnymede and Weybridge (Mr. Hammond) pointed out the need to protect the public from the possibility of misleading diagnoses by people who are not properly qualified or who might provide the wrong treatment. He gave an example that drew attention to the potential for serious abuse, given that a lot of therapies are provided one to one. Intimate touching may be part of a therapy and that could put the individual receiving treatment in a risky situation. His constituency example is probably not an isolated case and it should cause us, as legislators, to think about whether to take it as a warning and whether to provide protection for both parties.
In Committee, the Minister gave her reasons for resisting our amendment on alternative and complementary therapies, saying that the original clause 39 would provide adequate scope to cover the issue. The clause referred to services similar to those provided conventionally through health authorities and NHS trusts and also covered the


example that I gave earlier: 40 per cent. of GPs refer patients to complementary medicine. There are many members of the general public who, without going to a GP, seek treatment from complementary and alternative therapies. In reflecting on the reasons for rejecting our amendment, I am not satisfied that there is adequate protection.
I am sure that my hon. Friend the Member for Bosworth (Mr. Tredinnick) will seek to catch your eye, Mr. Deputy Speaker, because he has an interest in this area. On 6 April, in Westminster Hall, my hon. Friend made some interesting observations about aspects of complementary medicine that are already regulated; homeopathic doctors, since 1950, and osteopathy, since 1993, were examples. Already, some alternative and complementary therapies have a degree of regulation and protection. It is not unreasonable to look for an extension to cover some of the others.
The therapies are new and evolving; reflexology, for example, has been around for about 10 years and is now well understood by the public. I cannot see the argument that it is too new to be the subject of some protective legislation, similar to other alternative therapies.

Mr. Swayne: My hon. Friend makes a powerful case that the Bill provides the opportunity for such regulation, but not all of us are persuaded that, because the opportunity to regulate exists, it should be taken up. There are those of us on the Opposition Benches who are not entirely disposed to regulation for its own sake. If my hon. Friend could outline some of the regulations that she thinks might be made under the new clause, it would give us a greater sense of confidence in what she is spelling out.

Mrs. Spelman: I understand exactly where my hon. Friend is coming from. Ours is not a party that seeks to legislate unnecessarily; in fact, it is committed to trying to remove as much unnecessary legislation as possible. However, I referred earlier to a genuine constituency case, in which there has been a claim of serious abuse in a situation where an alternative therapy was being provided. A therapist was providing one-on-one treatment to someone who, in good faith, placed their trust in the practitioner as they would with a medical practitioner. Undoubtedly, members of the public would expect that trust not to be abused. However, it is claimed that it was. We must take that seriously, as it is likely that other examples exist. I can see the potential risk that that represents.

Mr. Burns: Does my hon. Friend agree that, as well as giving protection and peace of mind to the patient, the measure will give protection to the practitioner?

Mrs. Spelman: My hon. Friend makes exactly the point that I tried to make earlier; the new clause cuts both ways. It provides protection for the person seeking help through the therapy, but it also provides important protection—a title, in due course—for the practitioner, and sets out the necessary qualifications to assume the title. That helps to raise the status of that profession, and is entirely consistent with legislation introduced for the professions allied to medicine.
There are some difficulties in getting what was envisaged in the Health Act 1999 to work, and there are a lot of difficulties in devising the right structure for a diverse group of professions allied to medicine. None the less, the practitioners of those professions recognise the advantage that the measure gives to them; the protection of a title and a clear definition of their therapy and skills.
I do not think that the new clause falls into the category of onerous and unnecessary regulation. On the contrary, there is a need to protect patients who place themselves in a position of potential risk, trusting the professional in whose hands they have placed themselves not to abuse that trust. As I have said, we have examples of such abuse. I feel comfortable about promoting a new clause that would benefit both patients and practitioners of the new therapies.
We intend to remain entirely within the guiding principles of the Bill, which are extensive. The Bill proposes the establishment of a commission to regulate diverse types of care. It seeks to remedy some of the abuses that have occurred, in regard to which there is a consensus that additional protection should be provided. I am thinking particularly of children's homes. It also creates an opportunity for complementary and alternative medicines—some of which have been around for a long time—to be included in the legislation. I believe that failure to include them would constitute yet another inconsistency of the type that we have tried so hard to address from the outset of our debates on the Bill. The most notable inconsistency is the Government's willingness to regulate public and private care homes uniformly, along with their rejection of the application of the same principle to private and public hospitals.
I fear that, unless the new clause is accepted, practitioners in professions allied to medicine—and those seeking therapy from them—will be protected in terms of title and the definition of the qualifications necessary for practice, but complementary and alternative therapists will be out in the cold. Here is a legislative opportunity to put that right. It is not superfluous, and it is supported by the Institute for Complementary Medicine, which was pleased to observe an attempt to fill what it sees as a gap in the law. I therefore feel confident in asking the Minister to look at the matter again, and to reconsider her reasons for objecting to our original amendment. I hope that, following that reconsideration, she will have a change of heart.

Mr. Tredinnick: I welcome the new clause. I have been closely involved in complementary and alternative medicine in three Parliaments, as an officer of the all-party parliamentary group for alternative and complementary medicine. The new clause reflects the new-found importance of such medicine and its new-found status in this country.
There are three main reasons why we should welcome new clause 7. First, more and more people in Britain are using complementary and alternative medicine: it is no longer something for minority groups. It is now very much part of the nation's way of life and as such, it requires more attention. That is illustrated here by the fact that acupressure is now available in the House of Commons gym. There is a practitioner there, and some of us will have read in his leaflet the statement from an unnamed Member that it is the only way in which he or she can find any relief from stress. I think that I see the


Minister smiling, which is always encouraging. Perhaps she will let the new clause go through on the nod. I am sure that Conservative Members would welcome that.

Mr. Swayne: Will my hon. Friend let us know what acupressure is and precisely how the service that is provided in the gym will be augmented or enhanced by the regulation consequent upon the new clause, particularly as it seems to be so successful without the new clause?

Mr. Tredinnick: I am grateful to my hon. Friend for trying to help me along. Of course, I am just setting out, but all I say to him is that, if he had a headache, the practitioner might apply two thumbs either side of his head and produce a remarkable effect. [Interruption.] I shall give way to the hon. Member for Stroud (Mr. Drew) if he wants to contribute, albeit briefly, although if he does so, he may find that he is not promoted very quickly; I guess that the Government Whips will not approve.
I recommend that my hon. Friend the Member for New Forest, West (Mr. Swayne) tries that acupressure method. It is an illustration of how one can become more relaxed. I am not suggesting that he is not relaxed. In fact, I have always seen him as one of my more relaxed colleagues in the House and I always enjoy sitting next to him. Indeed, I could say, as a new ager might say leaving the Glastonbury festival, "I can feel the vibe sometimes." It is very relaxing being near my hon. Friend. However, we must not get too sidetracked. I would not want you, Mr. Deputy Speaker, to call me to order so early on.
I give another illustration of how complementary and alternative medicine has been received in the House. Recently, we had an exhibition in the Upper Waiting Hall, which was well supported by colleagues. Several Members from both Houses availed themselves of the treatments that were available. Colleagues do not normally bare their feet in public in the Upper Waiting Hall without good reason. Many colleagues, including me, queued up for the reflexology that was available on that occasion. [Interruption.] They did not include my hon. Friend the Member for West Chelmsford (Mr. Burns). I thought that he was nodding. Perhaps he hoped to have the treatment, but did not get it, or perhaps he is astonished at my suggestion.
The group provided treatment in the House. Whereas in the past, some of those treatments would have been seen as absolute quackery—if one discussed them with one's doctor, one would perhaps have been struck off the patients list—they are now the type of treatment that people expect to be available, and they have been available in the House of Commons.
The second reason why the new clause is relevant to the Bill is the greater use of complementary and alternative medicine in the national health service generally. The greater use of CAM in the health service started with fundholding GPs and has been taken up, with varying degrees of success, by primary care groups and, perhaps, primary care trusts. More and more people are using complementary and alternative medicine, and we now have greater use of complementary and alternative medicine in the NHS. Thirdly, we are looking at a new style of health provision overall—what is termed integrated health care: the combined use of conventional and complementary medicines.
My hon. Friend the Member for Meriden (Mrs. Spelman) touched on the exponential growth in the use and acceptance of complementary and alternative medicine. She gave some examples from the Sheffield study of the use of CAM by doctors. I could add to what she said. It has been established by a survey that 75 per cent. of the population want complementary and alternative medicine to be available on the NHS, and that between 20 and 25 per cent. of the population already use one form or another of complementary and alternative medicine. I need hardly tell colleagues that the fact that complementary and alternative medicine is a key interest for one quarter of the British population has profound political implications.
My hon. Friend the Member for Meriden also mentioned newspapers' interest in complementary and alternative medicine. The tabloid newspapers—such as the Daily Mail and the Daily Express, but also the others—have regular features on complementary and alternative medicine. The articles are not just one column long; they are usually four pages long. The Sunday newspapers, too, often have features on complementary and alternative medicine.
I have always felt that, in a sense, public opinion is ahead of the House on the subject of complementary and alternative medicine; unfortunately, we have often been behind on it.

Mr. Burns: How is it possible to judge successful treatment outcomes in alternative medicine compared with outcomes in more conventional medicine?

Mr. Tredinnick: There are many different complementary and alternative medicines, and outcomes are judged in different ways. The evaluations, too, are very different. One of the targets of the complementary and alternative medicine disciplines is to develop greater transparency, greater understanding of what works and—this is the subject of new clause 7—better, more effective regulation of complementary and alternative medicine providers. One of the points that I hope to develop later in my speech is that we are gradually establishing some order in the mass of those different disciplines.
The issue is important because of the great interest in complementary and alternative medicine. The United Kingdom population is voting with its feet on the issue. One can barely walk down a high street in Britain without coming across a health food shop selling complementary and alternative medicine products. One cannot go into a conventional chemist, such as Boots, without finding a whole range of homoeopathic preparations by one of the well-known providers, such as Nelsons. One can find Bach flower remedies and vitamins of every description on the high street. People are not mugs—they would not buy those things if they did not work. The fact is that there is great interest in and great demand for complementary and alternative medicine.
The concept of integrated health care is here to stay. Not only the Government but the Opposition have been addressing the issue of integrated health care. Way back in 1987, the all-party parliamentary group for alternative and complementary medicine set integrated health care as one of its principal targets. Undoubtedly, some of our distinguished colleagues, who are no longer with us, had vision and could see the issue's importance. It was only


10 years later that a watershed report on the issue was published by the Foundation for Integrated Medicine—which is the group that was established by the Prince of Wales, and has subsequently done much with the King's Fund to produce ideas on regulation that are acceptable both to conventional practitioners and to complementary practitioners.
The report—entitled "Integrated Healthcare: A Way Forward for the Next Five Years?"—was launched, at the Queen Elizabeth II conference centre, by the then Secretary of State for Health, the right hon. Member for Holborn and St. Pancras (Mr. Dobson). He not only spoke in favour of the report, but gave some money for research in complementary and alternative medicine. The report gave the medical profession a benchmark to work by. The very fact that those who ran the royal colleges and many highly respected medical practitioners were involved in the report has given it great credibility. The report has been fundamental in the acceptance and development of complementary and alternative medicine.
Earlier this week, at its request, I met the Royal Pharmaceutical Society of Great Britain, the offices of which are just over Lambeth bridge. I never thought of the society as being particularly interested in complementary and alternative medicine. However, it is the professional and regulatory body for all of Britain's pharmacists.
Professor William Dawson, who invited me to the society's offices, wrote:
We believe that there should be greater integration of complementary medicine into health care and that practitioners of orthodox and complementary medicine need to be encouraged to work together in all areas of practice.
When I met the professor and his team, he made it perfectly clear that he wanted pharmacists to act as a bridge between conventional and complementary medicine, and that he had every intention of facilitating better understanding of alternative therapies. It is instructive to us all and most encouraging that such an important society should be going down that track.
The next point in my argument supporting the new clause relates to the increased use of complementary and alternative medicine in the national health service. The person who really got the ball rolling—not in the last Parliament, but the one before—was the then hon. Member for Loughborough, now my right hon. Friend the Member for Charnwood (Mr. Dorrell), who as Under-Secretary, following meetings with the parliamentary group and others, produced a health service directive to the effect that if conventional practitioners took clinical responsibility for the actions of complementary therapists, they could engage their services and pay them out of the national health service budget. That was a significant breakthrough in the use of complementary and alternative medicine in the health service. When right hon. Friend became Secretary of State, he always kept a wary eye on that issue, supported by the then hon. Member for Bolton, West, Tom Sackville.
Let me say to the Under-Secretary of State for Health, the hon. Member for Birmingham, Edgbaston (Ms Stuart), that there has been a progression in the thinking in the Department of Health—a gradual move towards integration of the use of complementary and alternative

medicine in the national health service and integration of conventional and complementary therapies in mainstream medicine. That is our starting point.
The major development that followed my right hon. Friend's initiative was the introduction of GP fundholders, who were instrumental in spreading dramatically the use of complementary and alternative medicine. Under the arrangements that many of my hon. Friends will remember—and others who were not in the House at the time may not remember so fondly—a small number of doctors could get together and become GP fundholders. Therefore, doctors who were strongly in favour of complementary and alternative medicine could become fundholders and allocate a proportion of their budget to those therapies.

Mr. Deputy Speaker (Mr. Michael J. Martin): Order. The hon. Gentleman is straying from the new clause. Whether or not doctors support complementary medicine is neither here nor there. The new clause deals with registration and the hon. Gentleman must relate his comments to that.

Mr. Tredinnick: I am most grateful, Mr. Deputy Speaker. You are absolutely right to draw my attention to the new clause. I was talking about a type of registration, however, because those doctors could not practise unless they were registered as fundholders. The fact that they registered as fundholders provides the building block for some of the remarks that I want to make about the new clause, and I cannot make those points unless I refer to GP fundholders and primary care groups.
Another reason why we need the new clause relates to the primary care group system introduced by the present Government. New clause 7 deals with the registration of complementary and alternative medicine. However, there has been a real problem with primary care groups since the switch from fundholding. The reason for that is that the new boards are much larger and many of the health care professionals on them are not sympathetic to complementary therapies. Demand for complementary medicine has therefore dipped since primary care groups were introduced.
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A positive aspect of the Government's approach to the matter has been the initiation of trials using NHS funds. For example, the acupuncture trial was funded by the NHS executive in collaboration with the Foundation for Traditional Chinese Medicine. Such trials are very important in relation to registration. A stamp of approval from the NHS means that the treatments would be more acceptable to people.
The Minister knows that I have been saying for many years that there is not enough money for research. If registers and better regulation are to be introduced, more research into complementary and alternative medical therapies is needed.
My hon. Friend the Member for West Chelmsford is always helpful, and he asked earlier how we can know whether alternative therapies are effective. One way is through trials, and we need more of them. However, this is the same old chicken and egg problem: the Department


asks where the evidence is, and the complementary and alternative practitioners ask for money so that they can provide it.

Mr. Swayne: Will my hon. Friend give way?

Mr. Tredinnick: I see that I have stimulated my hon. Friend, without acupressure. I have not even had to put my thumbs to his temples.

Mr. Swayne: My hon. Friend says that the techniques are effective. I do not doubt that, but why should the Secretary of State be given the power to determine whether they are used? That power would be afforded to him in this awful new clause.

Mr. Tredinnick: My hon. Friend is emitting a different vibration. I do not pretend to be the most sensitive person, but I have noted the change in feeling on this Back Bench.

Mr. Bercow: My intervention will be comparatively prosaic, but new clause 7(3) confers on the Secretary of State the right to determine by regulation the method of application for registration and the means of its determination. I return to my usual hobbyhorse: does my hon. Friend agree that the regulations should be subject to the affirmative procedure of the House, and that they should not be left to the administrative fiat of a Secretary of State?

Mr. Tredinnick: My hon. Friend tempts me. I am Chairman of the Joint Committee on Statutory Instruments and of the House of Commons Select Committee on Statutory Instruments, and I have a great interest in affirmative and negative resolution procedures. I agree that an affirmative resolution procedure would be desirable in this case.
I have to declare another interest. I hesitate to answer his query in any other than a very friendly way, as my hon. Friend the Member for Buckingham (Mr. Bercow) is due to speak in my constituency on Friday. It is therefore especially important that I do not upset him, for fear that he will not make the kindly opening remarks that colleagues occasionally make about each other. That might not be helpful in the run-up to the general election, whose date was let out of the bag by the Minister of State, Foreign and Commonwealth Office, the hon. Member for Leicester, East (Mr. Vaz).
Let us be serious about this: my hon. Friend the Member for New Forest, West and other colleagues are on the right track about how the regulation works. I want to address that in a moment—[Interruption.] The Minister appears to be imitating my right hon. Friend the Member for Old Bexley and Sidcup (Sir E. Heath) when he occasionally enjoys a joke. Was it something that my hon. Friend the Member for New Forest, West did? Or was it something that I said?
To consider regulation and registration, we must, as my hon. Friend the Member for West Chelmsford said, deal with how complementary therapies interrelate and how they relate to conventional medicine. One of the difficulties of regulation is that complementary and alternative practitioners and patients tend not just to use one therapy, but to move between therapies until they find the one that works for a given ailment.
I should like to illustrate this with the true story of a child whose severely broken leg was repaired, with great skill, by a great surgeon. The child's parents wanted to do everything possible to help his leg repair. To support the surgeon's work, and with his agreement, they looked to complementary therapies to speed up the repair of the leg. To start with, they relieved some of the boy's aches and pains with the homoeopathic medicine arnica and used symphytum to help heal the wound, because the leg had been pinned. To encourage the bone to repair faster, they looked to traditional Chinese and ayurvedic medicine, which teach that one of the first things to do with a broken bone is to use frankincense and myrrh, which were, as we know, potent in biblical times. However, I am told by experts in traditional Chinese medicine that frankincense and myrrh bind bones. They are resins which help bone binding and encourage the healing process.
Another aspect that had to be addressed was the child's moods. They were helped using certain aromatherapy oils, such as lavender and mandarin.

Mr. Deputy Speaker: Order. I have to say that this is very interesting. I have listened to the hon. Gentleman speak in Adjournment debates, and I know that this is a favourite subject of his. However, alternative medicine is not specifically what we are debating in the new clause; we are debating registration. I cannot allow the hon. Gentleman to go into detail about the great things that alternative medicine does for people—perhaps another time.

Mr. Tredinnick: I am grateful to you for guiding me back on to the rails, Mr. Deputy Speaker. I will not pursue that line further, other than to say that, in the registration of practitioners and the way in which we regulate, we must bear in mind that there is often no clear distinction between the various therapies because they are used in combination. That is a fundamental issue which relates to the new clause that I wish to deal with in a moment.
Before I do that—and I hope it is in order—I wish to refer to the Select Committee in the other place. I think that I am allowed to call it the House of Lords, nowadays. You would have called me to order, Mr. Deputy Speaker, if I had called it anything other than the other place not long ago, and I am nervous because I do not want to be told that I am out of order.
In any event, the Select Committee on Science and Technology in the other place is currently considering complementary and alternative medicine and will soon produce its report. One of the issues that the Committee had to address was what is complementary or alternative medicine. That is germane to this debate on registration and regulation. What exactly are we regulating?
In 1976, I damaged my back in an accident and turned to a chiropractor, but I did not tell my GP. If I had done so, I would certainly have been ruled out of order. He would have told me that he would not treat me any more. That is how serious such matters were—it would have been the equivalent of suspension. However, under subsequent legislation—including the Osteopaths Act 1993 promoted by my hon. Friend the Member for North-East Cambridgeshire (Mr. Moss)—such therapies are regulated by statute. A person falsely claiming to be an osteopath commits a criminal offence and could incur a heavy penalty.

Mr. Swayne: There is more than one way to skin a cat. My hon. Friend points out that some years ago the doctor


avoided competition by refusing to treat him. However, have we not strung together those alternative professions under statutory regulation by the medical profession?

Mr. Tredinnick: My hon. Friend may be treading on politically incorrect ground by talking about stringing things together with catgut. As I am afraid of being called to order, I shall not pursue that point, if he will forgive me.
I have lost my place in my speech. When that happened to me some years ago, one of my hon. Friends helpfully intervened to remind me of what I had been saying. None of my hon. Friends is rising to do that. It is a bitter disappointment.

Mr. Burns: My hon. Friend was talking about his back.

Mr. Tredinnick: I am most grateful to my hon. Friend.
The serious point is that osteopaths and chiropractors are no longer considered to be beyond the pale; they have been integrated into conventional medicine. It is now debatable whether osteopaths are complementary practitioners at all. Furthermore, some therapies that were not even included in the list being considered for regulation by the House of Lords Select Committee—for example, crystal therapy, which is believed by some people to be beneficial—will probably enter mainstream medicine in the future.
After those brief introductory remarks, I shall turn to the body of my speech—[Laughter.] That is an old line, but it always works—especially when it is late and the House is exhausted. I definitely support new clause 7. We have heard about joined-up government; I am trying to achieve some joined-up opposition, so I point out to my hon. Friend the Member for Meriden that the new clause may need some fine tuning.
Many alternative and complementary therapists provide their services not only through the NHS, but in prisons and other places free of charge. To classify such a therapist automatically as someone who is
providing or offering for gain or reward services purporting or claiming to alleviate, cure, suppress or improve any condition
is not wholly accurate. I hope that the new clause is accepted on the nod, but that point may need to be addressed in another place.
12 midnight
I strongly support the proposal for a register of alternative and complementary therapists. There are about 50,000 complementary medical practitioners in the United Kingdom and it would definitely be appropriate to have some form of register.
I now come to the points of my hon. Friend the Member for New Forest, West about the style of regulation. I do not think that we should have a register that merely says that certain people are complementary practitioners. That would be impractical, misleading, dangerous and counter-productive. We have to draw on the way in which regulation has come about. That generally means that groups have bound together and agreed some form of self-regulation. They have then gone on to NVQ status—

Mr. Bercow: National vocational qualification.

Mr. Tredinnick: I am grateful to my hon. Friend.
The groups move from voluntary to statutory regulation and they can achieve that through the legislation that the Government, to their credit, introduced in the previous Session. They can achieve statutory regulation in a gradual way by binding together.
We will face major problems if we try to have one register. At the moment, there are 120 organisations representing alternative and complementary practitioners. The way forward is for the different groups in a particular discipline—for example, aromatherapy has four or five governing bodies—to work together progressively. That is what the chiropractors did. They were at loggerheads with each other and unfortunately they are at loggerheads again, but they at least came together to achieve regulation. The only practical way to proceed is to persuade organisations to work progressively towards statutory regulation. I want a register to be in place to denote the therapies in which the practitioners are qualified. It is not right to have just a general register.
Practitioners often face few formal obligations to meet a level of standards. It is possible for people to break away from one organisation to join another if they so wish. That is not good for public safety. We should move to 10 separate registers and perhaps then move to five separate registers, but the disciplines must be clearly delineated.
Self-regulation is the best and most appropriate form of regulation for complementary medical therapies. As I said, osteopathists and chiropractors have taken that approach, and I could have talked about the national occupational standards that homoeopathy, reflexology, hydrotherapy and aromatherapy have achieved. Each profession is developing at a different pace.
One of my colleagues touched on the issue of insurance, which is one of the ways in which practitioners become regulated. Insurance companies will not insure them unless they reach certain standards. More could be done to consider the way in which insurance companies are used.
I am slightly concerned at any proposal that will give the Secretary of State the power to decide the techniques that may or may not be employed in the delivery of services—although I was nearly called to order when I tried to develop that argument. Many services and disciplines overlap, which can create problems because it is a complex matter.
For example, the National Institute for Clinical Excellence does not have the machinery to assess homoeopathic medicines at, let us say, 1M. It has no chance because all its equipment will say that there is nothing in them. However, a homoeopathic medicine functioning at 1M is working at a level higher than the physical body. Bach flower remedies and Australian bushfire essences cannot be detected using conventional measures, so we need to think of new ways of assessing those medicines.

Mr. Swayne: Am I correct in my analysis that although he began by saying that he welcomed the new clause, my hon. Friend has, after detaining the House for half an hour, come around to opposing it, as I do?

Mr. Tredinnick: I would hate to be accused of having the two faces of Janus, the Greek god who faced in opposite directions. I welcome the new clause, and the fact that my hon. Friend the Member for Meriden has


tabled it in the proceedings on this Bill is a great milestone. Maintaining a register of alternative and complementary therapists is a good idea. However, I am slightly nervous about the Stalinist imposition of these measures through statutory instruments subject to the negative procedure.
This is a complex matter, and my hon. Friend the Member for New Forest, West has, in a sense, helped me. On the continent, draconian sanctions are in place against some therapists. Such sanctions are unnecessary. We would be better sticking to statutory regulation, but there should be flexibility in that.
The Under-Secretary of State for Health said that a complementary practitioner had been found to have acted improperly. What about all the doctors who have acted improperly? That is not a valid argument at all. There are policemen who act improperly. Normal mathematical distribution means that there are such people in every walk of life.
I say to my hon. Friend the Member for Meriden that I welcome the tabling and consideration of the new clause, and I say to the Under-Secretary that it requires careful consideration and a measured reply. I commend the new clause to the House.

Mr. Bercow: rose—

Mr. Tredinnick: I give way to my hon. Friend.

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. I thought that the hon. Gentleman had concluded his speech.

Mr. Tredinnick: I had not sat down, Mr. Deputy Speaker.

Mr. Deputy Speaker: Will the hon. Gentleman advise the Chair what he is seeking to do? It seems that he has finished his speech but is trying to give way to the hon. Member for Buckingham (Mr. Bercow).

Mr. Tredinnick: Out of courtesy to you, Mr. Deputy Speaker, I was not on my feet when you were on yours. I must admit that I had been about to sit down, but my hon. Friend wanted to intervene, and I felt that it would be a discourtesy on my part not to let him do so.

Mr. Bercow: I am grateful to my hon. Friend, whose courtesy and generosity are unsurpassed in the House. As the new clause requires the Secretary of State to determine the regulations, how does my hon. Friend think the experience of the right hon. Member for Darlington (Mr. Milburn) at John Marlay school, Stokesley comprehensive school, Newcastle university and Lancaster university, and as a senior business development officer in north Tyneside, has equipped him to determine regulations on alternative medicine and complementary therapy?

Mr. Tredinnick: My hon. Friend is helpful and raises an important point. It has long been a contentious issue between those in complementary and alternative medicine and Ministers in the Ministry of Agriculture, Fisheries and Food and the Department of Health that the committees that adjudicate on such medicine are not staffed by those

who understand the disciplines. In fairness to the Government, I acknowledge that the issue has been addressed, and new committees have been set up. My hon. Friend has made a valuable point, and I now intend to conclude my speech.

Dr. Brand: I am glad that the previous speech did not end prematurely.
I have absolutely no doubt that alternative and complementary therapies make an enormous contribution to people's feeling of health and well-being.
The definition set out in new clause 7(1) would catch almost any activity, because the national health service and all the other bodies set out in that subsection treat conditions such as feeling unhappy, feeling unwell, feeling unfit and not getting enough sleep, all of which are amenable to alternative and complementary therapies, just as they are amenable to food, wine, other drink—in moderation—and going to the hairdressers. There might be a need to ensure consumer protection in relation to the wide range of interventions to which we all submit ourselves—hairdressers should be just as much at risk of having their collars felt if they do something wrong as those who are in the business of tickling people's feet—but market forces could determine what is effective and what is not, and what is appreciated and what is not. The real problem is some of the claims made by some therapists.
Within my practice for the past 10 years—preceding fundholding—acupuncture, manipulative therapies, homoeopathy and hydrotherapy have been available to our patients. That has been achieved through clever arrangements with the private sector, whereby we sent them the odd patient who paid and they then saw our NHS patients. That arrangement worked extremely well.

Mr. Swayne: The hon. Gentleman is a physician. He is discussing complementary therapies, which are also competing therapies. Does he admit that if such therapies are to be regulated, that must be achieved without the influence of their competitors—physicians such as himself—affecting that regulation?

Dr. Brand: That is very difficult intervention to answer. I do not regard looking after people as a competitive event. I am always delighted when someone else can do it better than I can, because it means that they will have the hassle, not me—and the same is probably true of most of my colleagues. I am not sure that the hon. Gentleman has made a valid point.
The Prince of Wales's think tank produced an excellent paper, "Integrated Medicine", and I was present at its initial launch at St. James's Palace. The only therapies mentioned during that event, and those that formed the substance of the opus itself, were acupuncture, manipulative medicine, homoeopathy and hydrotherapy. That is not surprising, given that those four disciplines are well established: a body of work has been produced that shows that they have an effect and that, when handled responsibly, they are safe—in fact, far safer that some of the things that bog-standard medicine gets up to.
Incidentally, as the hon. Member for Bosworth (Mr. Tredinnick) says, acupuncturists, osteopaths and chiropractors are all adopting the PAMs—professions allied to medicine—route, whereby they become


registered and gain protection of title. They tend to be insured, and the insurance company will ensure that they have a certain competence.
My problem is with the phrasing of new clause 7, because its definition of an alternative or complementary therapist is someone who is
providing or offering for gain or reward services purporting or claiming to alleviate, cure
and so on. That basically means that anyone who says "I can make you better" becomes an alternative or complementary therapeutic specialist, and subsection (2) provides that the commission "shall maintain" such a person on a register—there is no condition attached. If I said that a Mars bar a day helped you work, rest and play, that would constitute a claim to offer better health, so I would be able to go to the commission and say that I wanted to be registered as a Mars bar therapist. The commission could do nothing about that. Under the new clause, it would have to register me. Subsection (3) states:
applications for registration shall be made,
so presumably the Secretary of State has an option whether I make the claim by post or turn up in person to demonstrate the size of my Mars bar.
12.15 am
We have a well-meaning attempt to introduce a measure of consumer protection where people are at risk of being ripped off or emotionally and physically abused, which does happen, with little sanction other than in criminal law or under trading standards. There should be a more established way in which some of the alternative therapies could be recognised as mainstream. We have already seen that with some of the manipulative interventions, and I have no doubt that others will follow suit.
We have had an in-depth and entertaining debate, which has taken us into the next day, but the new clause does not meet the requirements of the Bill, and I shall be surprised if the hon. Member for Meriden (Mrs. Spelman) pursues it.

Mr. Swayne: I shall confine myself exclusively to the new clause and avoid the wide-ranging analysis of the complementary therapies that my hon. Friend the Member for Bosworth (Mr. Tredinnick) drew to our attention. I mean no criticism—I found his exposition fascinating—I simply do not have the breadth of knowledge to comment on the areas on which he touched.
I am not hostile to these therapies. The key issue is whether the therapies will be improved by being regulated under the new clause. I took my son to an osteopath after a diagnosis that he needed grommets, and his head was manipulated. The hearing test was subsequently repeated by a conventional ear, nose and throat consultant, and—lo and behold—grommets were no longer necessary. So I have every confidence that many of these therapies work. The issue is entirely whether they will be assisted by the new clause.
My hon. Friend was eloquent in pointing out how these therapies have grown in status and extent during recent years. But that has happened without the benefit of the new clause, by which he laid so much store. I do not see

by what process the new clause would make matters so much better. When he told us of the acupressure available in the Palace of Westminster, I asked what it was and how it would be changed by and benefit from the regulations specified in the new clause. Interestingly, he answered only the first part of the question. He told me what it was; he did not go on to expand on how it would be improved or changed by the regulation to which he drew attention.

Mr. Tredinnick: I should have said that this type of acupressure adjusts the meridians, which are the energy lines in the body. According to traditional Chinese medicine there are a number of meridians. They are like different pulses. A traditional Chinese medical practitioner would take a range of different pulses. Through the massage of the feet—

Mr. Deputy Speaker (Sir Alan Haselhurst): Order. The hon. Gentleman is going into far too much detail, and away from the substance of the new clause. I cannot permit further discussion down that line.

Mr. Swayne: My hon. Friend has helped us enormously. The new clause provides an overarching regulatory framework for all those therapies. He has just described a therapy that does not lend itself in any way to the regulation of technique or of description, as specified in the new clause. The description that we have just heard is testimony to the fact that the therapies cover a wide range. We were told earlier of crystal therapy, whatever that might be.
The idea that such vastly disparate therapies could be covered by the same regulatory framework, as specified in the clause, is manifest nonsense. They are a consequence of very different life styles and religious backgrounds. I do not believe that they lend themselves to regulation in any way.
If we attend to the clause in some depth—I promise to be brief, as I see that some hon. Members are enjoining me to be so—we see that subsection (1) outlines the therapies that will be covered by the new provision. As the hon. Member for Isle of Wight (Dr. Brand) pointed out, it is extremely widely drawn. That subsection would encompass the healing ministry of evangelical priests. They would be included as healing practitioners.
Of course, alternative or complementary medicine derives part of its attraction from being precisely that: alternative. Much of its attraction might be jeopardised by bringing it into the medical establishment by such overarching regulation as is outlined in the new clause.
Subsection (3) states:
The Secretary of state shall provide by regulations the method by which—
(a) applications for registration shall be made—
that seems innocuous enough and entirely proper, but it continues:
(b) applications for registration shall be determined.
The Secretary of State will determine how applications for registration are to be determined—by what test, criteria or validity. We have just heard my hon. Friend's exposition about energies, crystals and all the rest. How on earth is the Secretary of State to draw up regulations to govern such things?
Subsection (4)(a) refers to


the description of the services provided by the alternative or complementary therapist.
The description that we heard was alternative enough. I listened to an exposition of what the osteopath had done to my child. I accept entirely that what he did worked, and that, as the Prime Minister says, what is right is what works—but the description was utter mumbo-jumbo. One might as well try to regulate witchcraft.
The fact is that the descriptions defy regulation. It is nonsense to provide the Secretary of State with a power to determine what the description should be and what is acceptable.

Mr. Tredinnick: May I ask my hon. Friend to put away his box of matches for a moment? I support what he said earlier about grommets. There is a well-documented case of a child being given one dose of a homoeopathic medicine and having the problem solved.

Mr. Swayne: I understand that. I do not dispute for a moment the effectiveness of alternative treatments. I know that they are effective. I have had experience of them in my own family, What I question is whether the Secretary of State is competent to regulate them in his capacity under the clause. The point is absolutely clear. Subsection (4)(c) refers to
the techniques which may or may not (as the case may be) be employed in delivery of such services.
It is not up to the Secretary of State to determine how therapies should be applied. In fact, having given his exposition on the therapies, my hon. Friend hit the nail on the head. He said that he supported the new clause, but came round at the end to saying, extremely lucidly, that regulation should not be as described in the clause, but should be self-regulation. That is what he said, and it is entirely proper.
Therapists should regulate themselves. I do not believe that an acupressurist could in any way regulate an acupuncturist. They are clearly separate therapies with quite different philosophies. They do not lend themselves to the sort of regulation outlined in the new clause.
Subsection (4)(d) contains an absolutely extraordinary provision, allowing for
any other matters relating to such services as the Secretary of State may specify.
If I were the Minister, I should leap at that with alacrity. Just think of the power being ceded to Ministers. I look to my own Front-Bench spokesmen for some explanation of the justification for giving Ministers such enormous powers.

Mr. Bercow: They will be the Ministers next year.

Mr. Swayne: Indeed, they will be in a position to exercise that extraordinary power, but I should like to know about their plans for doing so.

The Parliamentary Under-Secretary of State for Health (Ms Gisela Stuart): This has been a most interesting debate. At times, I felt in need of a dose of Bach rescue remedy, which I am sure is available not far from here.
New clause 7 seeks to give the National Care Standards Commission the responsibility to maintain a register of complementary or alternative therapists. As has been

amply illustrated, it would require the Secretary of State to make regulations providing for the method of registering and determining applications. It would further require the Secretary of State to make regulations as to the descriptions, claims and techniques used by therapists, and any other matters pertaining to them that he may specify.
We do not think the new clause necessary. We recognise that developments are moving apace in the provision of treatment and care services; in the range of settings in which they are provided; and in the equipment, techniques and technology through which they are delivered. We also recognise the need to ensure that the door is open to extend the range of services to be regulated in future, if and when necessary.
For that reason, the Bill already contains clause 42, which demonstrates the Government's forward-thinking approach to the regulation of social care and independent health care. It shows that we are building a new regulatory system that will last because it will have the flexibility to move with the times. Clause 42 provides for regulations to be made to bring further health care services within the new regulatory system, if or when considered appropriate at some time in the future. The clause must indicate the parameters of what that means. It has been drafted to refer to health care services that would include those that the hon. Member for Runnymede and Weybridge (Mr. Hammond) seeks to bring within the National Care Standards Commission's remit under new clause 7.
Independent health care services and establishments that will come within the new regulatory system from the outset are described in clause 2. Those services and establishments are those that we consider, having taken account of the consultation exercise held last year, to have the most pressing need to be regulated. They do not include complementary or alternative therapies. Bearing in mind the flexibilities in clause 42 to extend the regulatory scope of the National Care Standards Commission in future, we see no pressing reason to include such services in the Bill. Provision already exists to allow movement in that direction.

Mr. Hammond: Does the Minister acknowledge that the scope of private sector provision that can be regulated would be determined wholly by what the NHS chose to make available, or not to make available?

Ms Stuart: Some alternative therapies are already available in the NHS, but we simply do not think that the new clause is necessary.
The Government issued guidelines on professional self-regulation in complementary and alternative therapy that encouraged the formation of a single lead body to take forward self-regulation in each therapy. Steady progress is being made, particularly among the more popular therapies, and therapist registers are maintained by the lead bodies for each field. In addition to professional self-regulation, all practitioners of complementary and alternative medicines are subject to a range of general legislation that regulates the claims that they can make publicly, health and safety and the prescribing of medical products.
The new clause would give the National Care Standards Commission the responsibility to maintain a register of alternative and complementary therapists and to regulate


them. As I have explained, the consultation that we undertook on the regulation of independent health care indicated no pressing need for such measures. The Science and Technology Committee in the other place is currently conducting an inquiry into complementary and alternative medicine, and regulation of the professions is a major theme. In its hearings so far, the Committee has shown no sympathy for the idea of a single body to regulate all therapies. For that reason, the new clause is neither necessary nor appropriate and I ask the House to reject it.

Mrs. Spelman: I have, of course, listened to the observations made on all sides, and I would not pretend to have tabled a perfectly drafted measure. I have a residual concern: when tabloid newspaper headlines refer to one or perhaps more proven cases of abuse involving a therapist, the Government may regret dismissing so lightly the risk faced by the significant number of patients who seek alternative therapies without going through the NHS or the gateway of a GP. Clause 42, which refers to provision through the NHS or primary care trusts, does not cover such circumstances.
We have tried to warn the Government of the risks of leaving a wide range of therapies completely unregulated. I draw to the Minister's attention the example of hypnosis. Members of the public will be left exposed, and an opportunity to raise the status of some long-standing therapies has been missed. However, in the interests of making progress, I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.

New Clause 8

OLDER PERSONS' COMMISSIONER

'.—(1) There shall be an office of the Older Persons' Commissioner.

(2) Schedule (The Older Persons' Commissioner) shall have effect with respect to the Older Persons' Commissioner (referred to in this Act as "the Older Persons' Commissioner").'.—[Mr. Burstow.]

Brought up, and read the First time.

Mr. Burstow: I beg to move, That the clause be read a Second time.

Mr. Deputy Speaker: With this it will be convenient to discuss the following: New clause 9—Review and monitoring of arrangements—
'.—(1) The Older Persons' Commissioner may review, and monitor the operation of, arrangements falling within subsection (2), (3) or (4) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in safeguarding and promoting the rights and welfare of older persons to whom this Part applies.
(2) The arrangements falling within this subsection are the arrangements made by the providers of regulated services in England or Wales, or by the Secretary of State or the Assembly, for dealing with complaints or representations in respect of such services made by or on behalf of older people to whom this Part applies.
(3) The arrangements falling within this subsection are arrangements made by the providers of regulated services in England or Wales, or by the Secretary of State or the Assembly, for ensuring that proper action is taken in response to any disclosure of information which may tend to show—


(a) that a criminal offence has been committed;
(b) that a person has failed to comply with any legal obligation to which he is subject;
(c) that the health and safety of any person has been endangered; or
(d) that information tending to show that any matter falling within one of the preceding paragraphs has been deliberately concealed,

in the course of or in connection with the provision of such services.
(4) The arrangements falling within this subsection are arrangements made (whether by providers of regulated services in England or Wales, by the Secretary of State or the Assembly or by any other person) for making persons availableߞ

(a) to represent the views and wishes of older people to whom this Part applies; or
(b) to provide such older people with advice and support of any prescribed kind.


(5) Regulations may confer power on the Older Persons' Commissioner to require prescribed persons to provide any information which the Older Persons' Commissioner considers it necessary or expedient to have for the purposes of his functions under this section.'.
New clause 10—Examination of cases—
'.—(1) Regulations may make provision for the examination by the Older Persons' Commissioner of the cases of particular older people to whom this Part applies.
(2) The regulations may include provision about—

(a) the types of case which may be examined;
(b) the circumstances in which an examination may be made;
(c) the procedure for conducting an examination, including provision about the representation of parties;
(d) the publication of reports following an examination.


(3) The regulations may make provision for—

(a) requiring persons to provide the Older Persons' Commissioner with information; or
(b) requiring persons who hold or are accountable for information to provide the Older Persons' Commissioner with explanations or other assistance,

for the purpose of an examination or for the purposes of determining whether any recommendation made in a report following an examination has been complied with.
(4) For the purposes mentioned in subsection (3), the Older Persons' Commissioner shall have the same powers as the High Court in respect of—

(a) the attendance and examination of witnesses (including the administration of oaths and affirmations and the examination of witnesses abroad); and
(b) the provision of information.


(5) No person shall be compelled for the purposes mentioned in subsection (3) to give any evidence or provide any information which he could not be compelled to give or provide in civil proceedings before the High Court.
(6) The regulations may make provision for the payment by the Older Persons' Commissioner of sums in respect of expenses or allowances to persons who attend or provide information for the purposes mentioned in subsection (3).'.


New clause 11—Obstruction etc.—
'.—(1) The Older Persons' Commissioner may certify an offence to the High Court where—

(a) a person, without lawful excuse, obstructs him or any member of his staff in the exercise of any of his functions under regulations made by virtue of section (Review and monitoring of arrangements) (5) or (Examination of cases); or
(b) a person is guilty of any act or omission in relation to an examination under regulations made by virtue of section (Examination of cases) which, if that examination were proceedings in the High Court, would constitute contempt of court.


(2) Where an offence is so certified the High Court may inquire into the matter; and after hearing—

(a) any witnesses who may be produced against or on behalf of the person charged with the offence; and
(b) any statement that may be offered in defence,

the High Court may deal with the person charged with the offence in any manner in which it could deal with him if he had committed the same offence in relation to the High Court.'.
New clause 12—Further functions—
'.—(1) Regulations may confer power on the Older Persons' Commissioner to assist an older person to whom this Part applies—

(a) in making a complaint or representation to or in respect of a provider of regulated services in England or Wales; or
(b) in any prescribed proceedings,

and in this subsection "proceedings" includes a procedure of any kind and any prospective proceedings.
(2) For the purposes of subsection (1), assistance includes—

(a) financial assistance; and
(b) arranging for representation, or the giving of advice or assistance, by any person.

and the regulations may provide for assistance to be given on conditions, including (in the case of financial assistance) conditions requiring repayment in circumstances specified in the regulations.
(3) The Older Persons' Commissioner may, in connection with his functions under this Part, give advice and information to any person.
(4) Regulations may, in connection with the Older Persons' Commissioner's functions under this Part, confer further functions on him.
(5) The regulations may, in particular, include provision about the making of reports on any matter connected with any of his functions.
(6) Apart from identifying any person investigated, a report by the Older Persons' Commissioner shall notߞ

(a) mention the name of any person, or
(b) include any particulars which, in the opinion of the Older Persons' Commissioner, are likely to identify any person and can be omitted without impairing the effectiveness of the report,

unless, after taking account of the public interest (as well as the interests of any person who made a complaint and other persons), the Older Persons' Commissioner considers it necessary for the report to mention his name or include such particulars.
(7) For the purposes of the law of defamation, the publication of any matter by the Older Persons' Commissioner in a report is absolutely privileged.'.
New clause 13—Restrictions—
'.—(1) This Part does not authorise the Older Persons' Commissioner to enquire into or report on any matter so far as it is the subject of legal proceedings before, or has been determined by, a court or tribunal.

(2) This Part does not authorise the Commissioner to exercise any function which by virtue of an enactment is also exercisable by a prescribed person'.
New clause 14—Interpretations—
'.—(1) This Part applies to an older person to or in respect of whom regulated services in England or Wales are provided.
(2) In this Part, "regulated services in England or Wales" means services of a description provided by or in Part II undertakings for the time being provided in respect of older people, so far as provided in England or Wales.
(3) For the purposes of this Part, in the case of the services mentioned in subsection (2) the person who carries on the Part II undertaking is to be treated as the provider of the services.
(4) For the purposes of this section, an establishment or agency, and an undertaking of any other description, is a Part II undertaking if the provider of the services in question is for the time being required to be registered under that Part.
(5) Where the activities of an undertaking are carried on from two or more branches, each of those branches shall be treated as a separate undertaking for the purposes of this Part.
(6) Regulations may provide—

(a) for this Part to be treated as having applied to an older person at any time before the commencement of this Part if regulated services in England or Wales were at that time provided to or in respect of him;
(b) for references in this Part to older people to whom this Part applies to include references to persons who, at any prescribed time, were such older people.


(7) In this Part—
"information" includes information recorded in any form;
regulations" means regulations made by the Secretary of State or the Assembly.'.
Amendment No. 10, in clause 117, page 78, line 27, at end insert�ž
'( ) The provision which, by virtue of subsection (6), may be made by regulations under the Part of this Act which relates to the Older Persons' Commissioner includes provision amending or repealing any enactment or instrument.'.
Amendment No. 11, in clause 120, page 81, line 31, at end insert�ž
'Older Persons' Commissisoner Section (Older Persons' Commissioner
New schedule 2:—'The Older Persons' Commissioner—

Status

1.—(1) The Older Persons' Commissioner is to be a corporation sole.

(2) The Older Persons' Commissioner is not to be regarded as the servant or agent of the Crown or as enjoying any status, immunity or privilege of the Crown; and the Older Persons' Commissioner's property is not to be regarded as property of, or property held on behalf of, the Crown.

Appointment and tenure of office

2. Regulations may make provision—

(a) as to the appointment of the Older Persons' Commissioner (including any conditions to be fulfilled for appointment);
(b) as to the filling of vacancies in the office of Commissioner;
(c) as to the tenure of office of the Older Persons' Commissioner (including the circumstances in which he ceases to hold office or may be removed or suspended from office).

Remuneration

3. The Secretary of State shall—

(a) pay the Commissioner such remuneration and allowances; and
(b) pay, or make provision for the payment of, such pension or gratuities to or in respect of him,

as may be provided for under the terms of his appointment.

Staff

4.—(1) The Commissioner may appoint any staff he considers necessary for assisting him in the exercise of his functions, one of whom shall be appointed as deputy Commissioner.

(2) During any vacancy in the office of Commissioner or at any time when the Commissioner is for any reason unable to act, the deputy Commissioner shall exercise his functions (and any property or rights vested in the Commissioner may accordingly be dealt with by the deputy as if vested in him).

(3) Without prejudice to sub-paragraph (2), any member of the Commissioner's staff may, so far as authorised by him, exercise any of his functions.

General powers

5.—(1) Subject to any directions given by the Secretary of State, the Commissioner may do anything which appears to him to be necessary or expedient for the purpose of, or in connection with, the exercise of his functions.

(2) That includes, in particular—

(a) co-operating with other public authorities in the United Kingdom;
(b) acquiring and disposing of land and other property; and
(c) entering into contracts.

Reports

8. Regulations may provide for the Commissioner to make periodic or other reports to the Secretary of State and the Assembly relating to the exercise of his functions and may require the reports to be published in the manner required by the regulations.

Accounts

9.—(1) The Older Persons' Commissioner must keep accounts in such form as the Secretary of State may determine.

(2) The Older Persons' Commissioner must prepare annual accounts in respect of each financial year in such form as the Secretary of State may determine.

(3) The Older Persons' Commissioner must send copies of the annual accounts to the Secretary of State and the Comptroller and Auditor General within such period after the end of the financial year to which the accounts relate as the Secretary of State may determine.

(4) The Comptroller and Auditor General must examine, certify and report on the annual accounts and must lay copies of the accounts and of his report before Parliament.

(5) In this paragraph "financial year", in relation to the Older Persons' Commissioner, means—

(a) the period beginning with the date on which the Older Persons' Commissioner is established and ending with the next 31st March following that date; and
(b) each successive period of twelve months ending with 31st March.

Payments

13. The Secretary of State may make payments to the Older Persons' Commissioner of such amounts, at such times and on such conditions (if any) as it considers appropriate.

General

14. In the House of Commons Disqualification Act 1975, in Part III of Schedule 1 (certain disqualifying offices), the following entries are inserted at the appropriate places—
Older Persons' Commissioner.
Member of the staff of the Older Persons' Commissioner.

15. In the Northern Ireland Assembly Disqualification Act 1975, the same entries as are set out in paragraph 14 are inserted at the appropriate places in Part III of Schedule 1.

l6.—(1) Regulations may provide that the office of Older Persons' Commissioner shall be added to the list of "Offices" in Schedule 1 to the Superannuation Act 1972 (offices etc. to which section 1 of that Act applies).

(2) The Secretary of State shall pay to the Minister for the Civil Service, at such times as he may direct, such sums as he may determine in respect of any increase attributable to provision made under sub-paragraph (1) in the sums payable out of money provided by Parliament under the Superannuation Act 1972.'.

Amendment No. 12, in schedule 5, page 107, line 40, at end insert—'Older Persons' Commissioner'—
.—(1) The Part of this Act which relates to the Older Persons' Commissioner has effect, in relation to times before the commencement of any other relevant provision of this Act, as if references—

(a) to regulated services in England and Wales; and
(b) to the provider of such services,

were or included references to services which would be regulated services in England or Wales, or (as the case may be) to the person who would be the provider, if that provision were in force.
(2) Sub-paragraph (1) has effect subject to any provision made under sections 117 or 118.'

Mr. Burstow: The new clause introduces the proposition that the Government should establish an independent commissioner for the rights of older people, who would have a number of duties. I want to explain our concerns and why we thought it necessary to table the measure.
A piece of work published earlier this year by Action on Elder Abuse caused me to think that we needed a commissioner to advocate the rights of older people. That body, which is connected with Age Concern and a number of other organisations of and for older people, was established in 1994. In 1995, it set up a pilot helpline to give older people and their carers, friends and relatives the opportunity to report confidentially issues of abuse and other concerns. The service was rolled out nationally in 1998.
The report found that it was necessary to undertake a detailed analysis of two years' worth of calls to the freephone service to see what the trends were. Some 3,919 calls were analysed, of which some 1,564 were about incidents of abuse. As a country and a House, we have acknowledged and taken the necessary steps to start to address child abuse, but there is still too much of a taboo around the subject of the abuse of elders.
Action on Elder Abuse looked at how it would be appropriate to define such a subject. In 1994, a number of definitions were to hand. The definition that it alighted on—in the article "Listening is not enough"—is
A single or repeated act or lack of appropriate action occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.
That definition was signed up to by Action on Elder Abuse in 1995. The analysis bears some reflection. The organisation started by looking at the main types of abuse,


of which there are five. The first is physical abuse: hitting, slapping, pushing, restraining and over-medication, the last of which has been a particular concern of Members on both sides of the House for some time.
The second is psychological abuse: shouting, swearing, frightening, ignoring, blaming or humiliating.
The third is financial abuse, whether it be the illegal or unauthorised use of a person's property, money, pension book or other valuables.
The fourth is the sexual abuse of any person forced to take part in sexual activity without their consent.
The fifth is simple neglect; a person is deprived of food, heat, clothing, comfort or medication.
When the definitions are applied, a number of things emerge. It was found that three in four of the callers felt that abuse had occurred. Some 42 per cent. of the calls concerned alleged abuse in sheltered accommodation; 5 per cent. concerned abuse in hospital, 10 per cent., abuse in residential homes; 11 per cent., abuse in nursing homes; and 66 per cent. were concerned with abuse in a person's own home. The survey found that psychological abuse was twice as likely to occur as physical or financial abuse.
The findings of the research are disturbing, showing that abuse is taking place in a range of care settings. The number of people in a formal care setting is small and, given the substantial number of calls expressing concerns about those care settings, it is right to ask the Government to help older people, their relatives and others by providing a mechanism to flag up those concerns.
A director of older person's rights would be able to give a clear focus to the work of the National Care Standards Commission, and beyond it. He would be able to look across all care settings and establish a highly visible position to which people could turn in confidence, in the secure knowledge that their rights would be respected and their needs met.
I hope that such a post will be established in this country—even if it is not established by the Bill—and that a position will be created that has influence over policy makers at a national and local level; that has influence over practitioners; that ensures that there is compliance with minimum standards; and, crucially, that promotes respect for older people and their dignity.
Often when Ministers respond to such amendments, one of the lines of approach is that the amendments are technically defective. In this instance we have relied heavily on parliamentary counsel, because the new clauses and amendments bear a passing resemblance to proposals tabled by the Government to give effect to their commitment to establishing a commissioner dealing with the rights of children in Wales. I hope that Ministers will not deploy the same argument this evening. I hope that they will address the central concern about the need to raise the profile of issues affecting older people, in the context of abuse.
I accept that the Bill already deals with some of the matters to which I refer, but I believe that the new clause is a necessary additional step which would go a long way towards dealing with many of the worries that I—along with other Members and a number of outside organisations—have about the rights of older people and discrimination against them.

Mrs. Spelman: I shall be brief, because the hour is late. [Interruption.] I am keen to ensure that all the

remaining groups of amendments are given proper attention, and I am mindful of the fact that other Ministers are involved in those.
I entirely appreciate the needs described by the hon. Member for Sutton and Cheam (Mr. Burstow). They have been well expressed to all Members in publications by recognised voluntary organisations with real expertise, such as Help the Aged and Age Concern. Some of those publications have been excellent, describing in detail the problems experienced by older people. Probably the most moving is Age Concern's document "Turning your back on us", which deals with discrimination in the health service. However, I think the real question asked by the voluntary organisations is, "What is the most effective way of tackling the problem?"
I must tell the hon. Member that I am not persuaded that the best solution is the establishment of an older persons' commissioner. Very professional charities working with the elderly point out that we as politicians must beware any suggestion of tokenism. In a letter to me, Help the Aged expressed its fear that the creation of a Minister for older people—which has happened in Germany—would be a nine-day wonder in practice, and that the existence of one designated person to deal with such matters would make it too easy to compartmentalise. The absence of any real resources or power for that person would make it difficult to get things done.
Established voluntary organisations say that the problems of the elderly should be dealt with in departments where there is power to change the way in which things are done. In particular, they would like the national health service to stamp out all age discrimination in the service.

Mr. Burstow: Will the hon. Lady give way?

Mrs. Spelman: The hon. Gentleman has had his turn. Will he let me develop my argument a little?
In some very good work, the all-party parliamentary group on ageing and older people explicitly calls for NHS powers to be reinforced. The group says that it should be illegal for treatment to be refused to older people simply on the ground that they are older.

Mr. Burstow: I am listening closely to what the hon. Lady is saying. She has prayed in aid a number of the national charities that work for and on behalf of older people. Does she acknowledge that a number of them are, in coalition, campaigning for an entity—a commission, I think—to deal with age discrimination? Indeed, earlier today we considered, and voted on, a ten-minute Bill drafted by that coalition.

Mrs. Spelman: I think that we must be careful not to put words into the mouths of those voluntary organisations. Help the Aged has not specifically lobbied for an older persons' commissioner. That is not the conclusion reached by Age Concern in its document "Turning your back on us." I come back to my basic thesis. The important thing is to look at the powers that the Government have, to look at the way in which perhaps practice is slipping away from those existing powers and to bring it back to the basic principle of eradicating discrimination against older people simply on the ground of their age.
Help the Aged said specifically to me that it is anti the idea of a Minister for older persons because such special Ministers tend not to have the power and resources that are needed to get something done, so that is why I cannot support the specific outcome that the hon. Gentleman wants, although I identify with him on the need to do something about the problems.
I wish to see a vast improvement in the complaints procedure. The hon. Gentleman outlined a large number of complaints by older people about the way in which they are treated, but we need to look at the vehicles that they have to make complaints. Through an age summit that we organised in February, I have learned much about the problem that older people have in making complaints about the care that they receive. They are afraid that they may receive even worse care if they complain about it. Many older people are of a generation that was not encouraged to complain. For them, it is counter-intuitive to complain about the service, which is essentially free to them; they feel that they should not complain.
There is a strong case for advocacy for those older people. We would support that. However, although we agree with the extent of the problem, believe that the Departments have the powers to address some of those problems and want an improved complaints procedure, we cannot support that expression of the solution of the problem—an older persons' commissioner.
The hon. Gentleman sees a need for an older persons' commissioner—an older persons' rights director—and tries to make a parallel; his amendments mirror closely what is envisaged in the Bill for a children's commissioner. There is one important distinction between children and older persons in that respect: older persons have the vote; they have the right to vote. They are one in four of the electorate and the figure is rising. That is an important power, which they can exercise, making the Government of the day accountable for the treatment that older persons have received.
That is a logical argument for making a distinction between the two groups that we are seeking to protect. It is not that we do not believe that older people need protection. We believe that better and more effective tools can be used to address the problems that have been outlined.

Mr. Swayne: The hon. Member for Sutton and Cheam (Mr. Burstow) did well to remind us of the ten-minute Bill that was presented and given leave to be brought in earlier today. I would save the House's time if, instead of repeating them, I asked Members to read the exchanges on that Bill. The hon. Gentleman has drawn attention to a series of problems, which can be summarised as being due to ignorance, carelessness or indifference and wickedness. If a commissioner were created, I am not sure what leverage he would have over those human problems—problems of the human condition.
I believe that it is our responsibility here to defend the rights and interests of elderly people; we should not place our confidence in some commissioner to do it for us. Surely the purpose of the Bill is to lay down the conditions and standards by which elderly people in care should be treated, and not to hand that over following some knee-jerk reaction, saying, "If we had a commissioner, he would do all that for us."
The way in which the hon. Member jumped from the problem to the solution was not very persuasive. I did not detect in his comments any particular logic demonstrating that a commissioner would solve the problems that he described.

Mr. Burns: Does my hon. Friend think that, if we had had an old persons' commissioner 12 months ago, the commissioner could have secured for pensioners more than the measly 75p pension increase that they received in April? Do you think that an older persons' commissioner, if we had one—

Mr. Deputy Speaker: Order. May I tell the hon. Gentleman, who has some experience of the House, that he is now committing several misdemeanours—in the way in which he is addressing his hon. Friend, and in turning his back to the occupant of the Chair, whom he should be addressing?

Mr. Burns: I apologise, Mr. Deputy Speaker.
Does my hon. Friend the Member for New Forest, West (Mr. Swayne) think that, if we had had a commissioner, the commissioner would have been able to persuade the Government to act more swiftly on the conclusions of the royal commission on long-term care about how to help the elderly?

Mr. Swayne: I shall not follow my hon. Friend down that road, as I am sure that you would rule me out of order if I did, Mr. Deputy Speaker. I am convinced that the commissioner would deal not with wider political rights, but with treatment standards for the elderly as defined in the Bill. I suspect that my hon. Friend is right that, in the matters that he mentioned, such a commissioner would have made no difference whatsoever.
Nevertheless, the proposal hits the nail on the head. Some people say, "If only there were a commissioner, he would deal with the problem." Such thinking leads to hon. Members being negligent in assuming our proper responsibility. I believe that we have been negligent in accepting our responsibility. What have we done? In this Bill—rather than simply attending to the problems to which the hon. Member for Sutton and Cheam has drawn our attention and which we all already know exist—we should have formulated solutions to those problems and established the procedures by which they might be remedied. We have not done that at all: the Bill is an empty box.
All that we have done is effectively to give Ministers the power to take action later. The consequent regulations will not even be debated in the House before they are implemented. We are being asked simply to hand over the problem to Ministers, just as the hon. Member is asking us to hand it over to a commissioner. I believe that the new clause demonstrates the House's negligence in its responsibilities.

Ms Stuart: This has been an interesting debate, covering a wide range of issues related to care services for older people. Although the new clauses, amendments and new schedule in this group relate to a proposed commissioner for older people, such a proposal cannot be seen in isolation.
Older people form by far the majority of people receiving the care services that are dealt with by the Bill. There are literally millions of older people—a sizeable proportion of the population aged over 65—who rely on care services of one type or another to help them get the best out of life and to remain independent and active. Good-quality care services can make the crucial difference for older people between active participation in society in later years, and social exclusion and marginalisation. Therefore, the Government need no persuading of the importance of health and social care services for older people.
The hon. Member for Sutton and Cheam (Mr. Burstow) will not be surprised to hear me say that the Government do not intend to accept his new clauses and amendments. However, he and other hon. Members must not infer from that that the Government are not interested in the quality of care provided for older people, because nothing could be further from the truth.
We should not kid ourselves that creating an older persons' commissioner will determine whether the rights and interests of older people are protected. The health and social care services provided to older people throughout this country—their quality, accessibility, suitability, and the enhancement that they make to quality of life—depend on much more than the setting up of a new statutory post. I believe that the Government can claim with justice to be making greater improvements in the care services for older people than have been delivered by any previous Government.
The hon. Gentleman's new clauses talk about safeguards against abuse for older people. The Government have put in place a substantial programme of action to bring about improvements in the procedures for safeguarding older people from abuse, mistreatment and poor care standards.
Part I will set up the National Care Standards Commission as a powerful new watchdog against abuse and poor standards. The commission will work to new national minimum standards. We have already debated extensively the fact that national minimum standards for older people in care homes are being set for the first time, applying equally to all care homes, whether public, private or voluntary.
In future, care home providers will be clear about what standards they have to meet, and older people and their carers will be clear about the standards that they can expect. These will be aimed at promoting better quality care and helping to prevent abuse by grounding practice in the principles of dignity, choice, privacy and respect. The standards will guarantee residents access to an effective complaints procedure and ensure that vulnerable people are cared for by reliable and trustworthy staff who have been carefully recruited and properly trained to do their jobs.
The standards will also ensure that older people in care homes have the right to choose the way in which they live their lives—for example, when they get up or go to bed, what they would like to eat, and so on.
For the first time, older people living in their own homes will also be protected. The Bill introduces as part of the National Care Standards Commission's responsibilities a regulatory framework for personal home care services. In future, all domiciliary care agencies will be registered and inspected annually. That will provide a

greater assurance to the hundreds of thousands of older people for whom care in their own home is a lifeline and a means of staying independent.
Elsewhere in the Bill, part VII establishes for the first time a protection of vulnerable adults list that will identify people who have abused vulnerable adults, and ensure they do not have a second chance to harm vulnerable older people; and the establishment of a General Social Care Council will mean that better training and professional standards will apply to the care staff who work daily with older people.
In addition, looking beyond the provisions of the Bill, we have published new guidance, called "No Secrets", on preventing abuse of vulnerable adults. "No Secrets" deals with developing and implementing multi-agency policies and procedures to protect vulnerable adults, including older people, from abuse. Local multi-agency codes of practice will be developed and implemented by 31 October 2001.
Improving the care provided for older people is not just about preventing abuse. It is about making sure that services are up to standard, that the right services are available to meet people's needs, that there is no age discrimination in health or social care services and that health, housing and social care services work together to meet older people's needs rather than letting them fall through the gaps.
We are taking action across all those areas through a range of initiatives, including the long-term care charter; the development of intermediate care services to build a new bridge of care between hospital and home; the extension of direct payments to people aged over 65; the national strategy for carers; and the national service framework for older people.
I could continue in the same vein, but I will not test your patience, Mr. Deputy Speaker. The point that I am making is that the Government are taking real steps to drive up the standards of care services for older people. That is what older people want, and that is what the Government's priority should be. I do not think that it would be the best use either of the Government's energies or of public money to set up a commissioner concerned with older people's care services.
We believe that the new initiatives that we are developing and those already in place are the most effective way of advancing our commitment to better protect older people from harm and abuse, and to improve the quality of the care that they receive. We cannot sensibly consider the addition of an expensive national office before the new arrangements have even had a chance to work.
For those reasons, we believe that available resources should be spent first and foremost on raising the quality of care provided to older people in our society. I very much hope the hon. Gentleman will not press his amendments.

Mr. Burstow: Let me respond briefly to the interesting exchange that we have had on this group of amendments. We have sought to raise a number of concerns. We have concentrated on concerns about elder abuse, but other contributors to the debate have broadened the discussion to include the wider context of age discrimination. If the scope of the Bill had permitted it, we would have wanted


a broader remit for the proposed commissioner, so that the concerns of a number of the relevant charities about age discrimination could be addressed.
1 am
The ageist assumptions still prevalent in our society need to be challenged, as does the taboo about abuse of elders. As a society, we have decided to confront discrimination based on sex and gender, and we have decided to tackle racism. The House has decided also that we should do something about disability, and it is time that we decided to do something about age. The commissioner proposed in the new clause would have achieved that.
However, given the hour of the night and the contents of the debate, the best thing to do seems to be to withdraw the new clause, and return to the matter at a later stage.
I beg to ask leave to withdraw the motion.

Motion and clause, by leave, withdrawn.

Clause 1

CHILDREN'S HOMES

Ms Stuart: I beg to move amendment No. 46, in page 2, leave out from beginning of line 7 to "or" in line 9.

Mr. Deputy Speaker: With this, it will be convenient to discuss the following: Government amendments Nos. 47 to 49.
Amendment No. 33, in clause 2, page 3, line 5, leave out "services are" and insert—
'a substantial part of the services provided are services'.
Amendment No. 34, in page 3, line 11, leave out "any" and insert "a substantial part".
Government amendment No. 50.
Amendment No. 97, in clause 3, page 3, line 41, at end insert—
'; or
'(d) it is a sheltered housing development in which residents live in defined self-contained units and are supplied with nursing or personal care on a variable basis according to their needs'.
Government amendment No. 51.
Amendment No. 98, in clause 4, page 4, line 20, at end inser—
'( ) "Healthcare agency" means, subject to subsection (6), any undertaking which consists of or includes arranging the provision of direct medical services performed by nurses to people in their own homes, or any undertaking which consists of or includes arranging the provision of any personal or medical care performed by occupational therapists, speech therapists or physiotherapists to people in their own homes.'.
Government amendment No. 52.
Amendment No. 99, in page 4, line 42, after second "agency,", insert "a healthcare agency,".
Government amendments Nos. 80, 81 and 85 to 93.

Ms Stuart: I do not intend to detain the House, as these amendments are all tabled in response to concerns raised

by the hon. Member for Runnymede and Weybridge (Mr. Hammond) in Committee. I shall speak first to amendments No. 46 and Nos. 85 to 93.
In discussion on clause 1 in Committee, I undertook to consider whether it was necessary to exempt homes provided under section 82(5) of the Children Act 1989. That section allows the Secretary of State to arrange for the provision, equipment and maintenance of homes for the accommodation of children in need of particular facilities and services which are, in the opinion of the Secretary of State, unlikely to be available in community homes. This section of the Children Act 1989 replaced section 64 of the Children and Young Persons Act 1969.
The two youth treatment centres—the St. Charles centre in Brentwood, Essex, and Glenthorne in Birmingham—were established in the late 1970s under the 1969 Act. No homes have been established under section 82(5) of the 1989 Act.
In 1995, the St. Charles centre was closed, and Glenthorne will close on 13 July. I have taken the view that local authorities, the health service and specialist facilities in the private sector are better placed to care for the type of children placed in Glenthorne. I have therefore concluded that it is no longer appropriate for my Department to run such a child care facility and that we should withdraw from providing such a service.
Although there is no current intention of using section 82(5) of the 1989 Act to establish any more of these homes, its use cannot be ruled out at some point in the future. In those circumstances, it is my view that these homes should be regulated as children's homes by the National Care Standards Commission, and Government amendment No. 46 amends clause 1 accordingly. Government amendments Nos. 85 to 93 are consequential to bringing these homes within the regulatory framework.
I turn now to Government amendment No. 48. The Bill provides for independent schools that accommodate children for more than 295 days a year to be registered as children's homes. The reason for this dual registration is that, where children do not normally return home to their families during the holidays, they need the added protection that is provided by registration as a children's home.
Government amendment No. 48 will bring all boarding schools—that is, those in the voluntary and state sectors as well as the independent sector—into the dual regulation provision. It is important that children who spend more than 295 days a year in a boarding school, regardless of whether it is independent or not, should receive the added protection of being in a children's home.
In our Committee deliberations, the hon. Member for Runnymede and Weybridge tabled a number of probing amendments to find out exactly how we planned to use the power to except establishments and agencies from the definitions, contained in clauses 1, 3 and 4, of children's homes, care homes, domiciliary care agencies, residential family centres, fostering agencies and nurses agencies.
The hon. Member was concerned that we should not use the powers to exempt individual establishments or agencies from the requirement to register with the commission. I explained in Committee that it was certainly never our intention to exempt individual establishments or agencies from the definitions. We only ever intended to use the powers to except types of


establishment or agency. However, I am happy to put the matter beyond doubt, and I have therefore tabled these amendments to clauses 1, 3 and 4 today.
On amendments Nos. 49, 50, 80 and 81, there was much debate in Committee on the language used in the Bill to describe people with learning disabilities. It was felt appropriate that mental disorder should be defined in the Bill as an illness. It is quite right that "illness" is defined in what is now clause 120 in such a way as to include mental disorder, and that "mental disorder" is defined as including
arrested or incomplete development of mind
which covers learning disabilities.
On reflection, I agree with the hon. Member for Runnymede and Weybridge and other members of the Committee who spoke eloquently on the subject. I have therefore tabled amendment No. 80 to remove mental disorder from the definition of illness in clause 120. I have also tabled consequential amendments to the definition of a hospital in clause 2 and a care home in clause 3. The amendments separate mental disorder from illness and list it separately in its own right.
The last amendment in the group includes mental disorder in the definition of disability in clause 120. At the same time, we have taken the opportunity to update the language in these provisions to provide a more acceptable definition of "disabled".
I am grateful to members of the Committee for drawing our attention to these issues, as I believe that it has helped us improve the Bill in these important respects.

Mr. Hammond: I am grateful to the Minister for going through the list of Government amendments. All of them—unusually, in my experience—are in response to amendments that we tabled or points that we raised in Committee which the Government were prepared to accept in principle while wanting to come back with their own drafting.
I do not wish to do what the Minister has done and read out the purpose of each amendment. However, I have one or two points to make. On amendment No. 46, I am grateful to the Minister for taking our suggestion on board and giving effect to it in the Bill. Similarly, on amendments Nos. 47, 51 and 52, we have always taken the view that it would be iniquitous for Ministers to use these powers to exempt individual establishments or agencies. The Minister of State made it clear that that was not the intention, but the Bill did not make that clear beyond doubt. I am grateful to the Government for agreeing to amend the Bill to make that incontrovertible.
I am also pleased to see amendment No. 48. We tabled a similar amendment in Committee, which the Government rejected. It is good to know that Ministers occasionally go away, think again and then reintroduce the same amendment that they rejected in Committee. We are interested in strengthening the legislation, making sure that it is workable, and in reinforcing and underlining the principle of uniformity in treatment across the different sectors. Therefore, I shall not carp about the fact that it is not my amendment that will be accepted but the Minister's, which is in exactly the same form. I am just glad that we got there in the end.
Amendments Nos. 49, 50, 80 and 81 deal, as the Minister said, with the rather tortuous language in relation to learning disabilities. The Minister of State said in

Committee, that while he sympathised with the problems, he suspected that there might be some real technical difficulties because of the legacy of the language used in previous legislation and the way in which social care Bills have tended to build on each other. However, I am very pleased that the draftsmen have found a way round this. I think that the Minister was in the Committee when this was discussed, and she will agree that members on both sides felt genuinely uncomfortable that people with a learning disability were being defined as having an illness. In the early part of the 21st century, we should not characterise that condition as an illness. I am grateful to the Minister and her colleagues for addressing the problem.
My hon. Friend the Member for Meriden (Mrs. Spelman) and I tabled amendments Nos. 33 and 34. They address a simple, but potentially important, problem that could arise from clause 2. They would revise the definition of an independent clinic and an independent medical agency. The Bill provides that any establishment or agency that carries out any NHS work will be excluded from the definition "independent medical agency" or "independent clinic".
The problem arises because of the dual system of monitoring—the Commission for Health Improvement in the NHS and the National Care Standards Commission in the private sector, which has rather more teeth because it is able to deregister establishments or agencies when necessary. It cannot be right that, by performing a nominal service in pursuance of the National Health Service Act 1977, an establishment or an agency can move along the spectrum so as to be regulated under a different system.
The measure refers to
any…services provided…in pursuance of the National Health Service 1977 Act.
The amendment would change the word "any" to "a substantial part". The test would change. That establishment or agency would move from being regulated by the NCSC to regulation by CHIMP only when a substantial part of its services were being provided to the NHS. For example, if an independent medical agency provided out of hours services to a single GP for a small group of NHS patients, it would not be wholly excluded from NCSC control.
It seems common sense to us that the occasional provision of minor services to the NHS, at the margin, should not change the status of an establishment, any more than—as the Minister might argue—a hospital or NHS establishment that provided the occasional paid service to a private patient should be moved from the CHIMP to the NCSC system. Whether or not the Minister is minded to accept the amendments, I hope that she will acknowledge that there is a problem and will tell us whether she sees any other way to address it.
Amendment No. 97 would establish conclusively that the definition of "care home" cannot include units in a sheltered housing development. That issue has been raised again because some doubts, hesitations and concerns remain outside this place as to whether the Bill offers a proper and precise definition.
The issue is relevant because of the way in which the social security system determines the eligibility of individuals for housing benefit. If a sheltered housing development, where people occupied separate and individual units, was classed as part of a care home


because it was located on a site where services were offered to occupants—perhaps on an ad hoc or a la carte basis—there could be a danger that such people would not be eligible for housing benefit. Organisations outside the House have again raised that issue and I hope that the Minister will tell us whether she will accept this amendment. It would simply make clear in the Bill something that the Minister of State said in Committee was the Government's intention.
1.15 am
I wish to say something about amendments Nos. 98 and 99 which were tabled by the hon. Member for Sutton and Cheam (Mr. Burstow) and his colleagues. They deal with nurse-led care provided in the home not by an agency, but by the direct supply of a nurse-led service. The hon. Gentleman has done the House a service in raising this issue because a problems needs to be addressed. A well-publicised case in Essex illustrates the problems of a nurse—in that case a nurse in the NHS—working in the homes of individuals. There is a clear need to ensure that nurse-led services are properly regulated.
The Minister may accept the hon. Gentleman's amendments. However, if she chooses not to do so, she must tell the House how the Government envisage regulation of direct nurse-led care. I hope that she will not resort to telling the House that the Secretary of State's powers under clause 42 could be used to widen the scope of the Bill. We take the view that it is not satisfactory, when a Bill is not yet on the statute book, for a Minister to suggest that the use of regulatory powers to extend its scope is an adequate alternative to sending the Bill back in good order to the other place for further consideration.

Mr. Burstow: rose—

Hon. Members: No, no.

Mr. Burstow: I rise with encouragement from some Labour Members. I wish to speak briefly to amendment No. 97 and then consider the amendments that were tabled by me and my hon. Friend the Member for Isle of Wight (Dr. Brand).
The Government amendments are all very welcome. They address several concerns that were raised by the hon. Member for Runnymede and Weybridge (Mr. Hammond) in Committee. The hon. Gentleman, in describing amendment No. 97, rightly alighted on another issue that we explored in Committee when we considered clause 100, which also deals with definitions. Through amendments that I and my hon. Friend tabled, we examined the issues relating to definitions. One of the points that came up then was that the definitions of personal care that were in the Bill at that stage called into question whether sheltered accommodation, sheltered housing and extra supported housing schemes would suddenly find themselves bracketed with care homes.
The Minister gave us assurances in Committee that seemed to imply that the only way to deal with the issue was almost to do away with a single definition of personal care and introduce a multiplicity of definitions. That gave me grave cause for concern in terms of the tenor of Government statements about their long-awaited response to the royal commission on long-term care.
Amendments Nos. 98 and 99 return us to a debate that we had in the Committee's third sitting when I and my hon. Friends sought to clarify the definition of medical agencies. The Minister offered reassurances that led us to withdraw two amendments that sought to probe the Government's intentions on that matter. However, we have since consulted further and we feel that there is a gap in the definitions through which some providers may pass, unregistered and unregulated. The hon. Member for Runnymede and Weybridge described a recent case that goes to the heart of the matter.
We are trying to ensure that health care services at home which are not based in clinics or hospitals will be covered by the regulatory framework that the Bill will put in place. Some may be covered by the term "independent medical agency" as defined in clause 2(5), but that definition is inadequate. Although in Committee the Minister assured us that the definition of "nurses agencies" would cover all our concerns, the Bill deals with them only in their role as staffing bureaux, and not as direct health service providers.
Health services provided in the home by nurses without the need for supervision by a doctor can be extremely complex; for example, home blood transfusions and chemotherapy are two of the important services now being provided in that way. Professions allied to medicine, such as occupational therapy and physiotherapy, are understandably and rightly providing services in the home, and they do not appear to be included in the Bill's regulatory framework. None of those examples fits the definitions in the Bill.
A health care staffing agency provides temporary and permanent staff, and there is confusion about that. We hope that the Minister will be able to clear that up in her response. Historically, nursing agencies have provided a mix of health and social care services, and that is why, in the other place, nursing agencies were included in the Bill in an amendment. As things stand, however, it is possible that direct health care provided at home, which is not covered by the provisions on nursing agencies, will be left unregulated. Those services will be covered only if they are provided by a nurse under the control of the patient. We therefore tabled amendments Nos. 98 and 99 to flag up the concerns felt by several people who are involved in providing such services and who are anxious that they will not be covered by the regulatory framework.

Dr. Brand: Does my hon. Friend agree that a good example of such services are those provided by independent midwives? They may well deliberately work without the support of a medical practitioner, and patients' only protection is the opportunity to complain to a regulatory authority, which deals with professional standards rather than the care provided.

Mr. Burstow: My hon. Friend is absolutely right to use independent midwives as an example of the problem that we are flagging up. We hope that the Government will accept that there is cause for concern and that the problem needs to be addressed. As my hon. Friend said, patients' only recourse in respect of such practitioners is through the professional body that registers them.
The Government have accepted that there needs to be one agency for the registration of people, such as social workers, and another separate agency for the regulation and registration of agencies and establishments. We think that the same rule should apply in this case.
Doctors will be regulated by the Bill, but nurses who work on their own will not necessarily be regulated. My hon. Friend gave another example of a practitioner who works alone. Nurses and care assistants do not appear to be caught within the regulatory framework, and professions allied to medicine also appear to be outwith the Bill's scope.
We hope that the Minister will accept that our concern is real and that, even if the precise wording of our amendments is unacceptable to the Government on technical grounds, they will find a vehicle in the other place to enable them to close the loophole.

Ms Stuart: I shall respond first to amendment No. 97, which is intended to ensure that sheltered housing schemes are not required to register as care homes. I am aware that concerns have been raised about whether sheltered housing or supported accommodation will be registrable as a care home, so I want to reassure hon. Members that we do not intend to extend the requirement to register to new types of accommodation that have not previously been regulated.
Clause 3 defines a care home as one providing accommodation together with nursing or personal care for persons who are or have been ill; persons who are disabled or infirm; or persons who are or have been dependent on alcohol or drugs. The Registered Homes Act 1984 included the provision of board within its definition of a residential care home, but the Bill omits it from its definition of a care home, so as to ensure that providers who, to all intents and purposes, run care homes, but are currently able to avoid registration by operating pay-as-you-eat schemes, are required to register.
There is no clear definition of what constitutes sheltered housing and little consistency in the use of the term in the field. I assure the House that it is not the Government's intention to require schemes in which people live in their own homes and receive personal or nursing care to register as care homes. The great majority of such sheltered housing schemes involve care being provided to people in their own homes, and a person's own home, whether that person is a tenant or the owner, will not be registrable as a care home.

Mr. Burstow: I want to check one point. We are dealing with a Government Bill, yet the Minister is telling us that it sets out no clear definition. Surely the Government have it in their power to provide a clear definition?

Ms Stuart: I was attempting to explain the parameters of registration. A fear had been expressed that we would extend the requirement, so I was making clear our intentions.

Mr. Hammond: We are not suggesting that the Minister would deliberately attempt to extend the requirement. The intention behind the amendment is to ensure that she does not inadvertently do so.

Ms Stuart: I am grateful for the hon. Gentleman's concern to ensure that we do not make mistakes. I assure him that we shall do everything in our power to ensure that there is no unintentional extension. I can add little to what I have already put on the record in connection with amendment No. 97.
Amendments Nos. 33 and 34 deal with clause 2, which, as currently drafted, contains a provision designed to ensure that independent clinics and independent medical agencies, which are mainly small organisations, are properly regulated, but not over-burdened by regulatory or review bodies. The amendments would change that, and I am surprised that such an approach has been adopted. Clause 2 provides that independent clinics, such as privately run walk-in medi-centres, and independent medical agencies, such as organisations that arrange for doctors to provide call-out services for private patients, will be regulated by the National Care Standards

Commission only where they do not provide services to NHS patients. That is because services for NHS patients come within the remit of the arrangements that the NHS has in place to provide quality assurance. I have no intention of going into the arguments about whether the NHS and the independent sector should be regulated by the Commission for Health Improvement or by the National Care Standards Commission.
Clause 2 as it stands draws a clear demarcation of the National Care Standards Commission's role as regards independent clinics and independent medical agencies. Such establishments and undertakings will be regulated by the commission to the extent that they are wholly engaged in providing non-NHS services.

Mr. Hammond: The Minister is right, but our point is that, under the Bill as drafted, a private establishment that provides a service to a thousand private patients and one NHS patient pursuant to the National Health Service Act 1977 will cease to be regulated by the National Care Standards Commission. That strikes me as perverse and illogical.

Ms Stuart: I would be surprised if that theoretical example occurred in practice to any great extent. During our long discussions about how the regulatory scheme should work, we tried to establish a system which has the flexibility to enable providers to use the NHS and the private sector. The proposed amendments would change the balance which we felt was the right one. Where an independent clinic or an independent medical agency provided services for NHS patients, except where those services were a substantial part of its overall services, it would not only be regulated by the National Care Standards Commission, but would, to some extent, come under the NHS arrangements, for example, within the remit of CHIMP by dint of CHIMP's role in improving quality in the NHS.

Mr. Hammond: Is not that exactly what will happen in the case of an independent acute hospital that treats NHS patients?

Ms Stuart: It is a matter of horses for courses. The regulations should be relative to the size of the organisations. We consider that we have struck the right balance. We could discuss that further into the small hours, but we feel strongly that we have struck the right balance.
We would not welcome the change introduced by the amendments. We envisage that independent clinics and independent medical agencies will, in the main, be small businesses. Therefore, it is important that regulatory requirements strike the right balance, and they should not be over-regulated.

Dr. Brand: I should like to pursue the point made by the hon. Member for Runnymede and Weybridge (Mr. Hammond). Earlier, I referred to the provision of alternative medicines, where, not infrequently, one can persuade an alternative practitioner to accept someone as an NHS patient, as pro bono work, in exchange for the odd referral of paying patients. Such an establishment or sole practitioner would be providing a service to NHS


patients, under the Minister's definition. It may be a significant part of their clinical work load, although perhaps not of their financial turnover. Under those circumstances, would such a clinic have to register?

Ms Stuart: If the clinic or medical practitioners are providing NHS services, they will be supervised by the NHS; if they provide medical services, they will come under the commission. I may be missing the point. However, we consider that we have struck the right balance when an organisation provides independent and NHS services.
I also have doubts about the practicality of the proposed amendments. The extent to which they would apply to independent clinics and independent medical agencies—placing them inside or outwith the regulatory ambit of the National Care Standards Commission—would hinge on an assessment of whether a substantial part of their services were for NHS patients. Who is to say what "substantial" might mean in that context? The amendments would cause confusion all round. They would place an unnecessary burden on independent clinics and independent medical agencies, something which I thought the Opposition were keen not to do. They do not improve the current balanced provision in clause 2.
Amendments Nos. 98 and 99 would require health care agencies to be regulated by the commission. I am unable to accept the amendments. The National Care Standards Commission will have a big programme of work when it takes on its regulatory functions. Not only will it be regulating those services that health and local authority inspection units regulate at the moment, but it will be regulating new services such as local authority homes, small children's homes and private doctors. To allow it to carry out that work successfully, we must ensure that it is not overburdened when it is first established. We have to consider which services might provide the most risk to the most vulnerable in our community.
When we consulted last year on the regulation of private and voluntary health care, there was no particular suggestion that the services that are included in the definition of "healthcare agency", such as occupational speech or physiotherapy services, should be regulated. The Bill already provides powers for the National Care Standards Commission to regulate independent medical agencies, nurses agencies and domiciliary care agencies. If any of those agencies carry out services included in the definition of "healthcare agency", they will in any case be regulated.
It is important that occupational therapists, speech therapists and physiotherapists, if they are to be state registered. are already required to register with the Council for the Professions Supplementary to Medicine. Although we do not believe that it is appropriate to regulate health care agencies at present, I cannot say whether the position might change in the future. To allow us extra flexibility, we introduced amendments in Committee to what is now clause 42, which gives us the power to bring other health or social care agencies within the regulatory framework.
We have a responsibility to ensure that the commission is not overburdened in its early years. However, if there is concern in the future about the safety of services provided by health care agencies to vulnerable people, we already have the power in the Bill to require them—

Mr. Burstow: I am grateful to the Minister for giving way. It sounds as though the argument for rejecting the amendments is based solely on a concern about the work load that the commission will face in its early years. Surely that is in the hands of the Government, in so far as the Government will draft the minimum standards against which the commission will do its work. If the standards are not introduced at an early stage, the definition may be in the Bill, but it will not be implemented.

Ms Stuart: I do not entirely agree with that interpretation. The consultation dealt with the aspects that should be addressed first. It is a matter not just of work load, but of priorities. If there is genuine concern, we have the power to extend regulation to health care agencies in the future. That is important.

Amendment agreed to.

Amendments made: No. 47, in page 2, line 11, after "is" insert "of a description".

No. 48, in page 2, line 14, leave out "An independent" and insert "A".—[Mr. Sutcliffe.]

Clause 2

INDEPENDENT HOSPITALS ETC.

Amendment made: No. 49, in page 2, line 40, after "illness" insert "or mental disorder".—[Mr. Sutcliffe.]

Clause 3

CARE HOMES

Amendments made: No. 50, in page 3, line 35, at end insert—
'( ) persons who have or have had a mental disorder;'.

No. 51, in page 3, line 42, after "is" insert "of a description".—[Mr. Sutcliffe.]

Clause 4

OTHER BASIC DEFINITIONS

Amendment made: No. 52, in page 4, line 26, at end insert "description of'.—[Mr. Sutcliffe.]

Clause 10

INQUIRIES

Amendment made: No. 53, in page 7, line 22, leave out "it would be" and insert—
'there are exceptional circumstances which make it'.—[Mr. Sutcliffe.]

Clause 11

REQUIREMENT TO REGISTER

Mr. Hammond: I beg to move amendment No. 37, in page 7, line 36, at end insert—
'( ) Regulations shall provide that no person is required to be registered more than once with the Commission in respect of the same establishment or agency'.

Mr. Deputy Speaker (Mr. Michael J. Martin): With this it will be convenient to discuss the following: Government amendments Nos. 54 to 57.
Amendment No. 41, in clause 18, page 10, line 35, leave out "written".
Amendment No. 42, in page 10, line 37, at end add—
'( ) Representations under subsection (1) above may be made in writing or in person and an opportunity shall be afforded to a person served with a notice under section 17 to make representations in person in the manner prescribed by regulations'.
Government amendments Nos. 58 to 60.

Mr. Hammond: I see a gathering of Welsh Members who are anxious to move to the next groups of amendments, so I shall try to be brief.
Amendment No. 37 addresses the issue of multiple registration requirements. Because of the architecture of the Bill, establishments might be required to register several times, involving several sets of bureaucratic procedures and possibly the payment of several sets of fees. The amendment would insert into the Bill a provision that where a person registers in respect of an establishment, he will be required to register only once in respect of that establishment, even where it may require to be registered on different parts of the register because of what goes on in that establishment.
Amendments Nos. 41 and 42, in my name and that of my hon. Friend the Member for Meriden (Mrs. Spelman), deal with an important principle. Clause 18 provides that a person threatened with deregistration may make only written representations. There is an important issue at stake, because deregistration impinges on a person's right to practise his livelihood.
Through the amendments, we are asking for the right to be heard. I am not a lawyer, but the Minister is, so perhaps she will tell me in due course whether she agrees with me. It is a fundamental principle of our legal system that an individual has the right to be heard. In professional misconduct hearings, for example, under the requirements of employment law there is always a right to appear and to plead one's case. It is also a human rights issue, as the right to a hearing before an impartial tribunal is a fundamental part of the European convention on human rights.
No doubt the Minister will tell me that the procedure outlined in the Bill includes a right of appeal to a tribunal after the written representation has failed and deregistration is ordered. That is too late. The damage has already been done by then, and the reputation of the business is ruined. There must be an opportunity for a registered individual to be heard at first instance. That is possible under the Registered Homes Act 1984—the current legislation.
The Minister has in the past relied on a recommendation supposedly made by the report of the Longcare inquiry into a case in Buckinghamshire. That report apparently provided evidence that oral representation procedures had been abused to cause delay. No one condones abuse or delay of procedures, but it is incumbent on the Government to lay regulations ensuring that procedures are not abused. Fundamental and important rights cannot simply be removed because one or two people might be tempted to abuse them.
In any case, on careful consideration of the Longcare inquiry report, it is by no means clear that recommendation 31 supports the Minister's case. It is in fact based on an opinion given by the director of social services of Buckinghamshire on what might have happened had the county council sought to move for deregistration of the establishment in question. In fact, there was no move to deregister, so the issue of delay never arose. If the Minister carefully reads the relevant part of the report, she will find that that is the case.
The evidence on which the Government seek to remove an important right is of the flimsiest nature. I could read out details of the report, but, in view of the lateness of the hour, I shall spare the House that ordeal. None the less, I hope that the Minister will look sympathetically on my argument on an important point of principle.
Government amendments Nos. 54 to 60 are a response to a request made by the Opposition in Standing Committee to make it clear that conditions on registration could be not only varied at a later date, but removed. That means that conditional registration can be cleaned up once the conditions have been complied with. I am grateful to the Minister for taking the time and trouble to put that into the Bill.

Ms Stuart: I am grateful to the hon. Gentleman for drawing our attention to the issue covered in Government amendments Nos. 54 to 60. The Bill will be better as a result.
I come to amendments Nos. 37, 41 and 42. Amendment No. 37 adds nothing substantive to clause 11. If an undertaking is an establishment or agency required to be registered under the Bill—for instance, an independent clinic—the person carrying on or managing the clinic will be required to register only once because he or she is providing only one type of service.

Mr. Hammond: My point is that some establishments provide more than one service, such as an establishment in my constituency that provides respite care for children with cerebral palsy and day care for adults with learning difficulties. I understand that it will have to register twice.

Ms Stuart: The amendment is intended to provide that there is a need to register only once in respect of a single site or building, irrespective of the different services provided there. That is unacceptable, even if the same staff and premises are used for two different categories of establishment. It will be important to have a separate registration for each.
1.45 am
Different types of service—for example, an acute hospital and an independent clinic—provide different services and so will need to meet different regulatory


requirements. Applications will need to set out different information so that the registration authority can satisfy itself that standards are being or will be met. I hope that I have made clear the need for separate applications in respect of different categories of establishment. The amendment should not be accepted.
Amendments Nos. 41 and 42 would enable representations to be made in person or in writing when an individual received a registration authority's notice of proposal. The very same amendments were tabled in Committee, but, as I do not want to repeat those debates, I simply say that the Bill will not remove people's right to make representations in person. They will still have the opportunity to appeal to the tribunal, and the Bill merely provides that the registration authority can decide whether to take enforcement action without oral representations being made.
In Committee, the hon. Member for Runnymede and Weybridge (Mr. Hammond) said that he had been furnished with the view that the Bill's provisions for making representations would not comply with the Human Rights Act 1998. That is not the case: a person will be able to appeal to the independent tribunal and there will be an oral hearing. The authority's decision would not take effect until the tribunal had decided the case, unless the provider's registration had been cancelled under clause 20—the urgent procedure for cancellation. Before that, individuals would have had the opportunity to make written representations to the registration authority before it made a decision. At that stage, a misunderstanding could be cleared up or the authority could decide to take further action.
For the reasons that I have given—abuse of the existing provisions for oral representations in the Registered Homes Act 1984 and prolonging the risk to vulnerable people—I ask the House to reject the amendment.

Mr. Hammond: The Minister's arguments on amendments Nos. 41 and 42 were unconvincing and she did not address the question of the false premise, on which the arguments made in Committee by the Minister of State, the hon. Member for Barrow and Furness (Mr. Hutton), depended. I hope that the hon. Lady takes the trouble to consider recommendation 31 of the Longcare inquiry report in detail. Perhaps she will realise that the Government are removing an important right without good cause. However, amendment No. 37—the lead amendment—is relatively minor, so I shall not press it. [Interruption.] If Labour Members are so insistent, we might think again about amendments Nos. 41 and 42 at the relevant point. I beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 13

GRANT OR REFUSAL OF REGISTRATION

Amendment made: No. 54, in page 8, line 36, after "vary" insert "or remove".—[Mr. Mike Hall.]

Clause 15

APPLICATIONS BY REGISTERED PERSONS

Amendments made: No. 55, in page 9, line 21, after "variation" insert "or removal".

No. 56, in page 9, line 38, after "(stating" insert ", where applicable,".—[Mr. Mike Hall.]

Clause 17

NOTICE OF PROPOSALS

Amendment made: No. 57, in page 10, line 26, after "vary" insert "or remove".—[Mr. Mike Hall.]

Clause 19

NOTICE OF DECISIONS

Amendment made: No. 58, in page 11, line 16, after "varied" insert—
', the condition which is removed'.—[Mr. Mike Hall.]

Clause 20

URGENT PROCEDURE FOR CANCELLATION ETC.

Amendments made: No. 59, in page 11, line 32, after "varying" insert "or removing".

No. 60, in page 11, line 37, after "variation" insert ", removal".—[Mr. Mike Hall.]

Clause 22

REGULATION OF ESTABLISHMENTS AND AGENCIES

Amendment made: No. 61, in page 14, line 47, at end insert—
'( ) Before making regulations under this section, except regulations which amend other regulations made under this section and do not, in the opinion of the appropriate Minister, effect any substantial change in the provision made by those regulations, the appropriate Minister shall consult any persons he considers appropriate.'—[Mr. Mike Hall.]

Clause 61

CODES OF PRACTICE

The Parliamentary Under-Secretary of State for Wales (Mr. David Hanson): I beg to move amendment No. 62, in page 30, line 3, leave out "Secretary of State" and insert "appropriate Minister".

Mr. Deputy Speaker: With this it will be convenient to discuss Government amendments Nos. 63 to 66, 95 and 67.

Mr. Hanson: The amendments represent minor modifications to the clause that simply extend the power of direction to enable the National Assembly to direct a local authority in Wales to take account of any code of practice published by the Care Council for Wales. They will create powers parallel to those already prescribed for England. Indeed, they are essential requirements. The hon. Member for Runnymede and Weybridge (Mr. Hammond) raised those issues in Committee. We gave a positive response and have tabled the amendments.

Amendment agreed to.

Clause 66

FUNCTIONS OF THE APPROPRIATE MINISTER.

Amendments made: No. 63, in page 33, line 15, at end insert—
'(5A) Any functions of the Assembly under this section—

(a) may be delegated by the Assembly to the Welsh Council; or
(b) may be exercised by any person, or by employees of any person, authorised to do so by the Assembly'.

No. 64, in page 33, line 17, after "(5)(b)" insert "or (5A)(b)".

No. 65, in page 33, line 18, leave out "Secretary of State" and insert "appropriate Minister".

No. 66, in page 33, line 23, after "Act" insert—
'and, in respect of an authorisation given by the Assembly, references to a Minister included the Assembly'.

No. 95, in page 33, line 23, after "(5)(b)", insert "and (5A)(b)".

No. 67, in page 33, line 25, leave out subsection (7).—[Mr. Mike Hall.]

Clause 72

REVIEW AND MONITORING OF ARRANGEMENTS

Mr. Win Griffiths: I beg to move amendment No. 8, in page 35, line 23, after "may", insert—
'(a)'.

Mr. Deputy Speaker: With this it will be convenient to discuss the following: Amendment No. 9, in page 35, line 27, at end insert—
'(b) make recommendations concerning the operation of arrangements falling within subsection (2), (3) or (4) with the purpose of improving the effectiveness of those arrangements in safeguarding and promoting the rights and welfare of children to whom this Part applies; and
(c) when he considers it necessary, or when requested so to do by the Secretary of State or the Assembly, prepare and submit, to the Secretary of State and the Assembly, proposals for amending the provisions of this Act or any other enactment or instrument as they relate to regulated children's services in Wales.'.
Government amendments Nos. 83, 84 and 94.

Mr. Griffiths: I welcome the provision for a children's commissioner in the Bill, and the way in which the Government have acted since the Waterhouse report and other reports about the abuse of youngsters in care in Wales. I also welcome the way in which the Government have worked with the National Assembly for Wales in terms of clauses 71 to 77 and schedule 2.
However, I feel that my amendments will help to fine-tune and improve the Bill and the functions of the commissioner. The burden of the clauses is to emphasise the process and the functions that the commissioner will have in relation to individual children in regulated services in Wales.
The clauses are concerned with the duty of the commissioner to review and monitor the effectiveness of arrangements for safeguarding and promoting the rights and welfare of children participating in regulated children's services; the effectiveness of information disclosure; issues relating to criminality; the effectiveness

of advocacy and advisory support services to enforce the provision of certain functions with regard to information; assisting a child in making a complaint; and giving advice to any person who requests it. In schedule 2 there is a power to make periodic reports relating to the exercise of the functions of the commissioner.
What is missing is any positive note that the children's commissioner should make recommendations for the improvement of the provisions made in the Bill. In this, I claim no originality; I looked at the remit of the Equal Opportunities Commission, which could, on its own initiative or at the request of the Secretary of State, bring forward proposals to amend the Act or any other Act relating to its functions.
It would strike a positive note in the Bill if we could give the commissioner the power to take such initiatives, which would involve making a recommendation to the Secretary of State in cases of primary legislation—either this Act or Acts related to regulated children's services in Wales. However, recommendations could also be made about secondary legislation, which would be a matter for the Assembly.
In both cases, the commissioner could make recommendations, or either the Secretary of State or the Assembly could request the commissioner to consider whether there was a need to change legislation to make it more effective. I hope that the Government will feel that they can accept the amendments, as that would be a good signal to the National Assembly and people involved in regulated services for children in Wales. The commissioner would be more than a person dealing with process and functions, and would have the positive role of being able to recommend changes in legislation—for this House or the Assembly—to ensure that safeguards for children in care are kept at the highest levels.

Mr. Elfyn Llwyd: I welcome the proposal for the establishment of such an important post. Hon. Members will have some idea of how important my party thinks it is from the fact that my right hon. Friend the Member for Caernarfon (Mr. Wigley) spoke about it on 17 March. and my hon. Friend the Member for Ceredigion (Mr. Thomas) did so on 18 May.
I had the privilege of moving an amendment—in fact, it was a new clause—to the Local Government (Wales) Bill back in May 1994, with the aim of establishing just such a commissioner. I argued that the commissioner should
be responsible for the interests of children at all levels of policy and…ensure that current legislation is enhanced and that the current child-care agencies work together in close harmony in the best interests of children.—[Official Report, Standing Committee A, 24 May 1994; c. 627.]
The new clause was supported by all child care organisations in Wales and beyond, and by four royal colleges connected with health. Since then, there has been the Waterhouse inquiry. I congratulate the Government on having presented their proposals so promptly.
My new clause relating to the Local Government (Wales) Bill was supported by several Labour Members, and, indeed, by the current First Minister in the Welsh Assembly. It is interesting to note, for historical reasons, that much of the impetus for the creation of the commissioner's post has come from the Assembly, and I


have no doubt that it is supported by the First Minister. I am pleased that we have taken this vital step at long last. We need a better understanding of the problems, on an inter-agency basis. "Working Together", the guidance on the Children Act 1989, demanded better inter-agency working, but it has been a while coming. Today's children, obviously, are tomorrow's society, and we owe it to future generations to do all we can to ensure the well-being of society.
I believe that we are striking a blow for our children and for the future, but, as I have said, it has been a long time coming. That is not meant as a criticism of the Government, but there has been a reluctance to recognise the concept of children's rights, as opposed to the Victorian idea that children should be seen and not heard. The establishment of a children's commissioner for Wales was a key recommendation of the recent Waterhouse inquiry into the awful abuse of children in north Wales children' s homes and foster care.
I support the amendments tabled by the hon. Member for Bridgend (Mr. Griffiths). I seem to recall that he supported my new clause back in 1994; no doubt he, too, will be pleased that we have reached this stage.
We should pay regard to what the Welsh Assembly has said. It has said that it wants the commissioner to have a wide remit—not simply to deal with complaints, not even to liaise with various agencies, and not even to issue guidelines to local authorities and so on, but to take a role in the forming of policy that affects children.
On 3 July, I received a helpful letter from the Minister explaining some of the purposes of the Government's amendments and new clauses. I shall not give the details of the letter, but I hope that the commissioner will have a wide remit allowing him to deal not only with children in care, but with, for instance, circumstances in which current agencies and even the courts fail in their duties to children. I am thinking of circumstances in which a child's life is affected in any way. This may be a matter of general policy; it may involve a forum in which young people can discuss certain matters. I appreciate the whistleblowing aspect, to which the Minister's letter refers.
I hope that the commissioner will be able to formulate child-friendly policies in both the voluntary and the governmental spheres. I also hope that the establishment of this post will promote equal opportunities for the children of Wales, and that the commissioner will monitor the production of, for example, child impact statements. Much is expected of the commissioner. I hope that the office will live up to its name. I am delighted that it has been set up today, and I pay tribute to the Government for having moved so quickly.
I hope that, with the National Assembly, we shall be able to make a real go of the initiative. I am pleased that it was first considered in the National Assembly. In a way, it is a first for Wales. I hope that the Minister will assure the House that the office will have a broad remit and be able to take into account the important matters included in the amendments tabled by the hon. Member for Bridgend.

2 am

Ms Julie Morgan: I intend to be brief in supporting the amendments that have been tabled by my hon. Friend the Member for Bridgend (Mr. Griffiths). I am pleased to speak in support of them because he has an excellent track record in working for children in Wales.
I should like clarification on the points that my hon. Friend has made about whether the commissioner will have the power to make proposals to amend the Bill when it has been enacted, or any other legislation that relates to children in Wales. It is important that the commissioner has a proactive role and is able to make positive suggestions; that must be made clear. It is the Welsh Assembly's intention that the children's commissioner and the office of the children's commissioner should develop, and that the commissioner can promote the interests of all children in Wales, not just the children who are referred to in the legislation. It is important that we make the commissioner's powers as wide as possible in the Bill.
It is important to remember that the commissioner's duties already go way beyond children in care. There is a misconception in Wales that the amendments to the Bill would cover only children in care. We are covering much more: children in day nurseries, the fostering and adoption of children, domiciliary services and all the regulated services. All that goes way beyond children in care.
A voluntary body has expressed concern to me about whether the Welsh commissioner can be an advocate and champion for children as well as an impartial investigator of complaints that arise. I would like the Minister's comments on that. As I see it, the commissioner's office will be able to deal with the wishes and concerns of children in the areas covered in the Bill, which obviously goes far beyond simply investigating complaints. I hope that the Minister will be able to comment on that.
The National Assembly intends the office to go far beyond the impartial office of an ombudsman. One of its main functions should be, and will be—the Assembly wants it to be—to promote and monitor the United Nations convention on the rights of the child, to raise the profile, to improve public attitudes towards children and to be a proactive force in Wales. I should like the Minister's assurance that nothing in the legislation would prevent the Assembly from developing a wider remit for the commissioner and from taking on wider functions, initially, of course, on a non-statutory basis.
The establishment of the commissioner is an important development in Wales. This is one of the first pieces of legislation introduced here that has been requested by the National Assembly, and it is an example of the partnership between Westminster and the Welsh Assembly. I understand that the Assembly plans to involve children in the recruitment and selection of the commissioner. That is giving children a voice in the selection, and it is a tremendous step forward. It is important to remember that the commissioner will not be just one person. There will be an office for the commissioner, with different people who can undertake the different functions that we envisage the commissioner having.
I hope that the Minister will be able to reassure us that the commissioner will have the powers proposed in amendments Nos. 8 and 9, and that further legislation will


be introduced as soon as possible, in accordance with the wishes of the Assembly, to extend the commissioner's remit on a statutory basis to all children in Wales.

Mr. Hanson: The Government amendments in this group are minor and technical ones, tidying up the provisions for the commissioner.
I very much welcome the comments made by my hon. Friends the Members for Bridgend (Mr. Griffiths) and for Cardiff, North (Ms Morgan), and the generous welcome given to the Government's proposals by the hon. Member for Meirionnydd Nant Conwy (Mr. Llwyd).
The hon. Member for Meirionnydd Nant Conwy and my hon. Friend the Member for Cardiff, North asked about the Bill's development. On 15 February, Waterhouse recommended establishment of the position of a children's commissioner. On 2 March, we stated that we would table relevant amendments. Subsequently, in Committee, we tabled the amendments, and today we are tidying them up.
We shall sympathetically and urgently consider the National Assembly's wish for a wider role. However, I hope that both the hon. Member for Meirionnydd Nant Conwy and my hon. Friend the Member for Cardiff, North can accept that, although we are in discussions with the National Assembly, I cannot pre-empt a future Gracious Speech. Nevertheless, we shall certainly examine the possibility of expanding that role and fulfilling the full potential of the Waterhouse recommendations. I hope that that reassures the hon. Gentleman and my hon. Friend.
Amendments Nos. 8 and 9, which were tabled by my hon. Friend the Member for Bridgend, would include in the Bill a requirement for the children's commissioner in Wales to make recommendations to the Secretary of State or to the Assembly. I hope that I can reassure my hon. Friend that the concepts of reviewing and monitoring such arrangements, and the provision for reports by the commissioner, are intended to encompass the making of such recommendations as his amendments seek to ensure will be made. It is implicit in part V that the commissioner will be able to make the type of recommendations suggested by my hon. Friend. It is therefore not necessary, I hope, for specific provision on the matter to be included in the Bill.
My hon. Friends the Members for Bridgend and for Cardiff, North also mentioned amendments to legislation. They will both be aware that primary legislation remains principally a matter for the Government and the House, whereas devolved secondary legislation is a matter for the National Assembly. I assure my hon. Friends that I am confident that if recommendations are made in reports by the commissioner that relate to changes in either primary or secondary legislation, strong and due consideration will be given to amending that legislation. The commissioner's reports will carry tremendous weight in the matter.
I hope that I have been able to reassure my hon. Friend the Member for Bridgend on both those points, so that he will be able to withdraw his amendment. I genuinely welcome the general points that have been made in this debate, and I look forward to completing the remaining tasks at an appropriate parliamentary opportunity.

Mr. Win Griffiths: I thank my hon. Friend the Minister for that very positive response to this short

debate. I am sure that the words that will appear in Hansard will give great reassurance to everyone who works with children in Wales, both on the commissioner's specific power to recommend changes to primary and secondary legislation, and on development of the commissioner's role. I therefore beg to ask leave to withdraw the amendment.

Amendment, by leave, withdrawn.

Clause 78

AMENDMENT OF CHILDREN ACT 1989

Mr. Hammond: I beg to move amendment No. 45, in page 40, line 1, leave out subsection (8).

Mr. Deputy Speaker (Sir Alan Haselhurst): With this it will be convenient to discuss the following amendments: No. 13, in page 40, line 6, leave out from "is" to end of line 9 and insert—
'any person, authority or agency (referred to in this Part as the Registrar) prescribed by the Secretary of State, and reference to the Registrar's area are references to England.'.
No. 4, in page 40, line 20, leave out "regular contact with" and insert "proximity to".
Government amendment No. 68.
No. 5, in page 40, line 37, leave out "regular contact with" and insert "proximity to".
No. 7, in page 40, line 48, leave out from beginning to end of line 5 on page 41.
No. 14, in page 41, line 20, leave out "Chief Inspector" and insert "Registrar".
No. 6, in page 41, line 31, leave out "regular contact with" and insert "proximity to".
No. 15, in page 41, line 44, leave out "Chief Inspector" and insert "Registrar".
No. 16, in page 42, line 2, leave out "Chief Inspector" and insert "Registrar".
No. 17, in page 42, line 25, leave out "Chief Inspector" and insert "Registrar".
Government amendments Nos. 69 to 71.
No. 18, in page 46, line 36, leave out "Chief Inspector" and insert "Registrar".
No. 19, in page 46, line 41, leave out "Chief Inspector" and insert "Registrar".
No. 20, in page 47, line 1, leave out "Chief Inspector" and insert "Registrar".
No. 21, in page 47, line 6, leave out "Chief Inspector" and insert "Registrar".
No. 22, in page 47, line 9, leave out "Chief Inspector" and insert "Registrar".
No. 23, in page 47, line 12, leave out "the Chief Inspector" and insert—
'Her Majesty's Chief Inspector of Schools in England'.
No. 24, in page 47, line 15, leave out "Chief Inspector's" and insert "Registrar's".
No. 25, in page 47, line 21, leave out "Chief Inspector" and insert "Registrar".
No. 26, in page 48, line 7, leave out "Chief Inspector" and insert "Registrar".
No. 27, in page 48, line 13, leave out "Chief Inspector" and insert "Registrar".
No. 28, in page 48, line 16, leave out "Chief Inspector" and insert "Registrar".
No. 29, in page 48, line 35, leave out "Chief Inspector" and insert "Registrar".
No. 30, in page 48, line 37, leave out "Chief Inspector" and insert "Registrar".
Government amendment No. 72.

Mr. Hammond: I hope that all the Welsh Members present will not leave the Chamber, because the regulations that we are debating apply in both England and Wales, and there are some important issues to be addressed.
I should like, first, to deal with the Government amendments in this group—amendments Nos. 68, 69, 70 and 71—which were tabled to address issues raised by the Opposition in Committee. My notes say that I should express gratitude to the Government for doing that. However, as I have already done that several times today, I am beginning to wonder whether the Government should not be expressing gratitude to us for tidying up the sloppy drafting of their legislation for them. Either way, we have worked together to ensure that the Bill is tidier, more explicit and, we hope, better than when we started.
Amendment No. 45 seeks to delete clause 78(8). Clause 78 is a long and complex clause introducing a number of new sections into the Children Act 1989. The amendment would remove subsection (8) of the proposed new section 79A to the 1989 Act.
The proposed new section provides for the registration of child minders, who are defined by the Bill as people who look after children in their own homes—that is, the home of the person minding the children. It specifically excludes people who come to the parents' home to look after their children—in other words, nannies, babysitters and so on. So far so good—but on the basis that it is the intention not to interfere with what the Under-Secretary of State for Education and Employment, the hon. Member for Barking (Ms Hodge), described as certain informal arrangements, subsection (8) excludes any child minding between the hours of 6 pm and 2 am. Those hours are disregarded in determining whether or not a person is required to be registered as a child minder under the Bill.
I probed the matter in Committee and the Under-Secretary replied to the points that I raised. I am sorry that she is not here this evening. I am sure that the Under-Secretary of State for Wales, who seems to be a multi-purpose Minister, practising joined-up government by dealing with child minding as well as Welsh affairs, will be well briefed on what the hon. Lady said in Committee.
I have just noticed what appears to be a misprint in the Bill, which refers to
any time between 2 am and 6 pm
I am pretty certain that the Bill should refer to any time between 6 pm and 2 am; even at this hour we still have our wits about us. The only reasoning that the hon. Lady was able to adduce in support of the decision to exclude child minding between the hours of 6 pm and 2 am was that she used to leave her children with a neighbour and pay her neighbour some pocket money as a reward. That is the informal arrangement that the Under-Secretary did

not want to include within the scope of the Bill. How informal that arrangement was in terms of whether the Chancellor of the Exchequer benefited from the reward that was given is a subject for discussion on another day.
If a child is looked after between 9 am and 5 pm, that must be regulated child minding. The person who looks after the child has to be registered; the premises in which they do the looking after have to be inspected and they have to meet requirements governing the suitability of the premises and anyone who may be there—husbands, boy friends, lodgers or whoever. If a child is looked after in the same place between 6 pm and 2 am, however, the person doing the looking after is not required to be registered. The premises are not required to be inspected and there are no requirements as to the suitability of other people who may be on the premises.
I am not an expert on child abuse, but it is pretty much common sense that a child being looked after in someone else's home is likely to be at more risk during the evening than during the day. The Minister will correct me if I am wrong, but the evidence points to alcohol being a factor in the physical abuse of children. I would guess that the sort of people who might be undesirable to have around when young children are being looked after by a child minder are more likely to be present in the evening than during the day. I can see no justification beyond expediency for the exclusion that the Bill proposes.
2.15 am
I am not sure that I am entirely comfortable with the Bill's regime for regulating child minding. The question of exclusion of care in the parents' home strikes me as an anomaly, but I accept that practical difficulties mean that the line has to be drawn somewhere. However, regulations require some consistency, and proposed new section 79(8) must go. The message that it sends out is that places where middle-class parents who work conventional nine-to-five hours leave their children must be regulated, to reassure those parents. In contrast, parents who work evening shifts and who have to leave their children with child minders between 6 and 10 pm—

Mr. Stephen Pound: That is us.

Mr. Hammond: No, the hon. Gentleman is wrong. It is now 2.16 am. Under the Bill, we would fall within the regulated period of time. However, if the hon. Gentleman were to collect his child at 1.58 am, the person looking after the child would not be required to register as a child minder. That is absurd. Parents working shifts need people to look after their children in the evenings. They will find that those people are not required, under the Bill, to be registered and regulated.
That is a clear anomaly. It is based on nothing more substantial than the personal experience of the Under-Secretary of State for Education and Employment, who told the Committee that she used to leave her children with a neighbour—a revelation that made hon. Members in the Committee feel uncomfortable, regardless of party. The hon. Member for Don Valley (Caroline Flint) had something to say about the proposal on behalf of parents working shifts.
The distinction is absurd and unacceptable. It rests on expediency alone and creates an unacceptably uneven playing field between children cared for at different times of day. It would mean that arrangements for children cared for by child minders at the times of most risk would be unregulated, whereas those governing children cared for in the mornings and afternoons would be regulated.
That would be highly unsatisfactory, and even the Under-Secretary was hard put it to defend it in Committee. I hope that the Minister has considered the matter and that he has some good news for us.
Finally, I assume that the Minister will correct the erroneous transposition of 2 am and 6 pm in the Bill before it proceeds to the Lords. I should be grateful if he would confirm that.

Dr. Brand: First, I wish to indicate the support of my party for the comments of the hon. Member for Runnymede and Weybridge (Mr. Hammond). The specific importance of treating child minding performed later in the day in the same way as that performed in daylight hours stems from the benefit payments and tax credits that may be available to working families. It seems iniquitous that registered child-minding facilities should be available during the day but not at night, when there is no requirement for child minders to be registered. The resulting unfairness will be hard on shift workers and those who work irregular hours.
I shall not speak to every one of our amendments, because there are rather a lot of them. The Minister will recognise our main amendment because it mirrors exactly a Government amendment that was brought forward in Committee in relation to the registration function in Wales. The initial amendment specified an education inspector for this part of the Bill. After a lot more discussion and consultation in the Principality, it was decided that it would be safer to have the flexibility of having a registrar or a registering authority rather than specifying a particular agency other than the Assembly.
It is too late in the day for us to rehearse a lot of the arguments. Many of my colleagues think that Ofsted is not the right agency for the regulation of child minding and day care—and not only because its track record as an agency suggests that it is not supportive of vulnerable establishments. Given the fear that Ofsted manages to engender in quite large schools, I wonder what effect it will have on vulnerable child minders. However, I will leave that aside.
There is an important philosophical issue here. I see child care and day care as a social care rather than an educational issue. One must be careful not to allow the educational umbrella to spread too wide. Having said that, we clearly lost that argument in the turf wars between the Department of Health and the Department for Education and Employment. One must accept that the Government are intent that Ofsted will carry out this very important work.
I accept that the Government have every right to do that. However, I have some problem as to whether they are wise to put that in the Bill. There is a very interesting example in amendment No. 72. In the past three weeks, the Government have felt it necessary to change in the Bill the title of the person carrying out a particular piece

of work, presumably because the job title has changed in those three weeks. Does that now mean that that individual's job can never be retitled because primary legislation might be needed for him or her to carry on with the same work? If so, it is ridiculous.
I invite the Government to think again about whether it is sensible to tie themselves, in primary legislation, to one particular organisation and, indeed, one particular post. It would be extremely difficult. The only sanction that the Government would have if they did not get on with their chief inspector of schools—who may be excellent at inspecting schools but useless at regulating child minding and day care—is to sack the individual, rather than saying, "If we don't get it right, we will transfer your service over to another agency."
At times, we ask the Government to be too prescriptive in their Bills. Their response is that we should not tie their hands but give them the flexibility so that another round of primary legislation is not necessary if they need to change things by regulation. I invite the Government to give themselves the opportunity to revisit a decision that they have made today. I hope, for the sake of the children about whom we are talking, that they do not have to revisit their decision, but it would be a tremendous shame if that could not be done because of a lack of legislative time or parliamentary procedure.

Mr. Hanson: As the hon. Member for Runnymede and Weybridge (Mr. Hammond) acknowledged, the Government amendments were tabled in response to representations made to us in the Standing Committee. I hope that shows that we are a listening Government and that co-operation in Committee can serve a valuable and interesting function.
The hon. Gentleman was concerned about a possible misprint. My reading is correct. There is an explanation, and to save time, I shall write to him about the matter. I assure him that the Bill is correct, but, for clarity, I shall write to him.
The main thrust of the hon. Gentleman's amendment is that there should be regulation for child care at all hours, whether at home or elsewhere. The issue is simple; it boils down to whether the Government should deal with such matters, or whether parents should decide which of their friends or neighbours they leave their children with for the evening. Should that be a judgment for the Government or for parents?
As we made clear in Committee, the purpose of the exemption is to avoid the regulation of informal care arrangements. The Government understand that such care is most likely to be provided during the specified hours. Any reduction would only cause more informal arrangements to be caught within the remit of the regulations. I am sure that the Conservatives do not want more opportunities for regulation on matters such as child care. An important principle is involved.
The proposal to lift the exemption would bring within the scope of registration anyone who babysits in their own home in the evening for reward. We held significant discussions of that matter in Committee. It was emphasised that informal arrangements are outside regulation and the Government believe that parents should be responsible for them. Although we accept that there may be some concerns, it would be difficult to regulate such child care—we would be intruding on parents'


private arrangements. The hon. Member for Runnymede and Weybridge may disagree with that. In essence, I reiterate the points made in Committee.
The hon. Member for Isle of Wight (Dr. Brand) raised several important issues. There are differences between the arrangements in England and Wales.

Dr. Brand: Before the Minister deals with my amendment, will he address the issue of benefit payments to working parents for child care? Will he discuss that matter with his colleagues in other Departments? If he is saying that child care does not have to be provided by a registered child carer during the specified hours, is it possible for parents to claim tax benefits for unregistered child care? It is vital that we treat workers equally, irrespective of the time of day at which they work.

Mr. Hanson: I shall look into that matter and discuss it with my colleagues. The question is about parental choice at that time of the evening and whether we should intrude by introducing regulation to cover that time. The Government judged that we needed to draw a line and we have done so, as we explained in Committee. However, I shall respond to the hon. Gentleman when I have discussed the matter with the appropriate ministerial colleagues.
As the hon. Gentleman is aware there are differences between England and Wales on these matters; they were well rehearsed in detailed discussions in Committee. The amendment would certainly offer the possibility of removing responsibilities from Ofsted in England. I can reassure the hon. Gentleman that, given Ofsted's track record on taking on new work, he need not be quite so anxious as he appears to be. It is appropriate that such a fundamental decision should be taken through secondary legislation. The matter is important; it is for the House to consider. That is why the provision is in the Bill. We have discussed the arrangements in detail.

Dr. Brand: Will the Minister give way?

Mr. Hanson: No, because I want to finish my point. We had considerable discussion in many sittings in Committee on the roles and responsibilities of Ofsted and on the position in Wales. The Government have made it clear that the Bill will give Ofsted the responsibility for the sector that we are discussing. The matter has been discussed and the changes to be made are a matter for secondary legislation in due course. I urge the hon. Gentleman to reflect on that and to take the opportunity to see how the provision operates. At some point, we can return to it in future.

Mr. Hammond: I was not sure to which amendment the Minister was speaking, but it was not to amendment No. 45.
I have now recovered my wits and the Minister has no need to write to me about the times. I see that the provision is framed in the negative, and I understand that the excluded hours are between 6 pm and 2 am.
I am disappointed that the Minister has not taken the opportunity to remove an illogicality from the Bill. My amendment offered one more lifeline to the Government to try to remove a banana skin and a provision that is

likely to rebound on them in the not too distant future. He said that a line has to be drawn somewhere and that the Government were anxious not to impose additional regulation in respect of early-evening arrangements undertaken by child minders. Equally logically, however, he could have said that the Government had therefore decided that it was not appropriate for exactly the same child-minding arrangement to be regulated if it took place in the afternoon or in the morning.
The amendment was an attempt to resolve an obvious anomaly in the Bill, which had been identified and commented on by hon. Members on both sides of the Committee. It is clear that the Government do not wish to take the opportunity to resolve it, so I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Amendments made: No. 68, in page 40, line 34, leave out "and every prescribed person".
No. 69, in page 44, line 36, leave out "The regulations may make" and insert—
'Any regulations made under this section shall include'.
No. 70, in page 44, line 36, leave out "for".
No. 71, in page 45, line 35, at end insert—
'( ) Where an order has been so made, the registration authority shall, as soon as is reasonably practicable after the making of the order, notify the local authority in whose area the person concerned acts or acted as a child minder, or provides or provided day care, of the making of the order.'.
No. 72, in page 52, line 26, leave out—
'the Chief Inspector of Schools'
and insert—
'Her Majesty's Chief Inspector of Education and Training'.—[Mr. Mike Hall.]

Clause 79

BASIC DEFINITIONS

Amendment made: No. 73, in page 53, line 22, after "clinic" insert ", independent medical agency".—[Ms Stuart.]

Clause 91

PERSONS REFERRED FOR INCLUSION IN LIST UNDER PROTECTION OF CHILDREN ACT 1999

Amendment made: No. 74, in page 61, line 22, leave out "or 2A" and insert ", 2A or 2D".—[Ms Stuart.]

Clause 98

TRANSFER FROM CONSULTANCY SERVICE INDEX OF INDIVIDUALS NAMED IN PAST INQUIRIES

Amendments made: No. 75, in page 67, line 8, at end insert—
'and in paragraph (a), for "this section" there shall he substituted "section 1 above"'.

No. 76, in page 67, line 22, leave out "this section" and insert "section 1 above".—[Ms Stuart.]

Clause 103

SUITABILITY TO ADOPT A CHILD: SEARCHES OF LISTS

Amendments made: No. 77, in page 70, line 22, at beginning insert—
'( ) The Police Act 1997 shall be amended as follows.'

No. 78, in page 70, line 22, leave out'—
113(3A) of the Police Act 1997'
and insert "113 (criminal record certificates)—
( ) in subsection (3A)'.

No. 79, in page 70, line 23, at end insert—
'and
( ) After subsection (3D) (inserted by section 89) there shall be inserted—
(3E) The references in subsections (3A) and (3C) to suitability to be employed, supplied to work, found work or given work in a position falling within subsection (3B) or (3D) include references to suitability to be registered—

(a) under Part II of the Care Standards Act 2000 (establishments and agencies);
(b) under Part IV of that Act (social care workers); or
(c) for child minding or providing day care under Part XA of the Children Act 1989, or under section 71 of that Act or Article 118 of the Children (Northern Ireland) Order 1995 (child minding and day care)."


( )In section 115 (enhanced criminal record certificates)—
(a) in subsection (5)—
(i) after paragraph (e) there shall be inserted—
(ea) registration under Part II of the Care Standards Act 2000 (establishments and agencies);
(eb) registration under Part IV of that Act (social care workers);" and
(ii) after paragraph (g) there shall be inserted—
(h) a decision made by an adoption agency within the meaning of section 11 of the Adoption Act 1976 as to a person's suitability to adopt a child." and
(b) in subsection (6A), after "113," there shall be inserted "or his suitability to adopt a child,".'.—[Ms Stuart.]

Remaining Government amendments agreed to.

Order for Third Reading read.

Motion made, and Question proposed, That the Bill be now read the Third time.—[Ms Stuart.]

Mr. Hammond: The lateness of the hour clearly calls for brevity, but it would not do justice to the process that the Bill has undergone if I did not make one or two comments.
I would not like the length of this evening's proceedings and the fact that the opposition parties—ourselves and the Liberal Democrats—have felt the need to raise further issues to obscure the fact that, by and large, the Bill has passed through the House with a fairly strong spirit of consensus behind it. Some difficulties have been identified with specific matters of implementation, but the principles behind the Bill are supported on both sides of the House. I would like to place that fact once more on the record.
The Bill is not perfect, but the substantial dependence on regulations to make it work, which was one of our significant concerns during earlier stages of its consideration, now becomes a strength. We have not finished with the Bill because, in the coming months, and

perhaps years, the Government will issue a stream of regulations that will put the meat on its bones. We will be looking to engage constructively with the Government to ensure that it becomes proper, working legislation.
I shall certainly be taking up the offer that the Minister of State, Department of Health, the hon. Member for Barrow and Furness (Mr. Hutton), has extended to myself and Liberal Democrat representatives to participate in the consultation process on standards and regulations. In that way, I hope that we will be able to ensure that the legislation is workable and robust.
I cannot speak for my noble Friends and other noble Lords who may take a different view of the substantial changes that have been made to the Bill since it came from the other place. It started life there, and I know that several noble Lords have a sense of ownership towards it. It may yet be possible that we in this place will see it again—who knows what will happen when it returns to the other place?
The Minister of State is not present, probably because he is preparing for a Standing Committee early in the morning. He has dealt with the issues that we have raised and the dozens, or perhaps hundreds, of amendments that we have tabled with great diligence, courtesy and good humour throughout. Sometimes, I sense, his patience has been sorely tested, but he has never allowed that to show, or at least not very often.
Although it may not always seem like it to the Minister, the points of difference between him and us are relatively small. The main difference is that, from where he is sitting, he can afford to take a much more relaxed view of the use of secondary legislation than we can. Perhaps if I were doing his job, I would be able to take that relaxed view too. [HON. MEMBERS: "Dream on."] Well, in time.
I end by congratulating the Minister on getting his Bill through the House. I hope that whatever disagreements there have been along the way, we can all work together to try to ensure that, as the regulations are drafted and adopted, we have robust and workable legislation that will achieve the objective that we all share, which is to improve the quality of care to some of the most vulnerable people in our society.

Mr. Burstow: I wish to associate myself and my hon. Friend the Member for Isle of Wight (Dr. Brand) with the comments that the hon. Member for Runnymede and Weybridge (Mr. Hammond) has just made about the Minister of State and the way in which he has conducted the Government's part in Committee, and I extend that to other Ministers who took part in the Committee's deliberations. I think that it is appropriate to single out the Minister of State because he had to carry the larger burden in dealing with the Bill.
The Bill is very important and, although 2.38 in the morning may not be the time to trumpet that fact, it is worth putting on the record our feeling that introducing this regime for regulating and inspecting a host of care settings is a vast improvement on what has gone before. The previous system was a hotch-potch and did not give adequate safeguards to vulnerable people, and the Government are to be applauded for putting in place a regime that goes a long way to doing just that.
There are still gaps, and I hope that, when their lordships consider what we have done in this place, they will feel that there is still more that can be done to improve the Bill. Hon. Members on both sides of the House want to ensure that vulnerable people, including the elderly and children, are given the safety, security and standards of care that we would want for our own parents and children and for ourselves.
The Bill should receive a Third Reading; it is a good Bill, and it deserves our support.

Question put and agreed to.

Bill accordingly read the Third time, and passed, with amendments.

WELSH GRAND COMMITTEE

Motion made and Question put forthwith, pursuant to Standing Order No. 108 (Welsh Grand Committee (sittings)),
That the Welsh Grand Committee shall meet on Wednesday 19th July at half-past Ten o'clock at Westminster.—[Mr. Mike Hall.]

Question agreed to.

DELEGATED LEGISLATION

Motion made and Question put forthwith, pursuant to Standing Order No 118 (6) (Standing Committees on Delegated Legislation),

IMMIGRATION

That the draft Special Immigration Appeals Commission (Procedure) (Amendment) Rules 2000, which were laid before this House on 27th June, be approved.—[Mr. Mike Hall.]

Question agreed to.

FOOTBALL (DISORDER) BILL

Ordered,
That, if a Bill entitled the Football (Disorder) Bill is presented and read the first time, notices of Amendments, new Clauses and new Schedules to be moved in Committee in respect of the Bill may be accepted by the Clerks at the Table before it has been read a second time.—[Mr. Mike Hall.]

DATA PROTECTION

Motion made,
That the Motion in the name of Mr. Secretary Straw relating to the salary of the Data Protection Commissioner shall be treated as if it related to an instrument subject to the provisions of Standing Order No. 118 (Standing Committees on Delegated Legislation) in respect of which notice has been given that the instrument be approved.—[Mr. Mike Hall.]

Hon. Members: Object.

Default Judgments

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Mike Hall.]

Mrs. Anne Campbell: I am pleased to have this opportunity to raise the case of my constituent, Derek Birch, and to tell the House how he has been disadvantaged and prevented from seeking justice because of the way in which the law on default judgments is currently framed; he now faces ruin, with payment of all costs. I shall begin by filling in the background to the case. I should make it clear that I do not expect my hon. Friend the Minister to comment on an individual case. I raise Mr. Birch's case to illustrate a specific point in law that my hon. Friend might want to reconsider in the light of events.
Mr. Birch has a lifelong dream of owning a horse, and he has a passionate and consuming interest in dressage and drag hunting. In early 1996, his trainer, Angela Niemayer, told him that she had found just the horse for him and strongly urged him to inspect the horse—Waltrap—at the Russian Horse Society in Epsom. Mr. Birch made it plain that he was looking for a horse trained in and skilled at dressage. He was told that the previous owner, a Cambridge lawyer, Mr. Duncan Samuel, was too busy to ride the horse himself.
Susan Hodges, a friend of Mr. Birch, accompanied him when he inspected the horse. The woman from the RHS who sold him the horse is called Mrs. Lansley, and Mr. Ron Meddes, a director of the RHS, was also present. According to Miss Hodges, Mrs. Lansley understood very well that Mr. Birch was looking for a dressage horse and she went to some lengths to convince both Mr. Birch and Miss Hodges that Waltrap would be entirely and eminently suitable for Mr. Birch's purposes.
In 1996, Mr. Heathcote, a veterinary practitioner, examined Waltrap for the purpose of ascertaining the horse's suitability for Mr. Birch's purposes. The horse was passed fit for
Riding club/competition/medium level dressage/drag hounds mount.
Letters from Mr. Heathcote confirmed that he discussed Mr. Birch's needs at length with the RHS, especially with Mrs. Lansley. In August 1996, Mr. Birch entered a contract with Duncan Samuel and/or the RHS for the purchase of the horse for £5,500. His cheque paying for the horse was made payable to Regine Lansley of the Russian Horse Society. The horse's previous owner, Mr. Samuel, was company secretary to the society at the time of the sale.
Unfortunately for my constituent, it transpired that five months prior to the sale, in March 1996, the horse had been diagnosed as osteoarthritic, osteochondritic and a false rig. I understand that the latter term applies to a horse that is castrated late and badly, which can make the horse dangerous and often results in the horse having to be destroyed. Mr. Alan Heath, a veterinary surgeon employed by Mr. Duncan Samuel, made the diagnosis, but that was, of course, not revealed to my constituent until some time later. The revelation took the form of a statement made by Mr. Heath to Surrey trading standards officers.
Waltrap was clearly not worth £5,500 and was not at all suitable for drag hunting or dressage. There is evidence suggesting that, under Mr. Samuel's ownership, the horse had never been formally schooled; it had never attended formal instruction, never hunted and never hacked, nor even left the yard. Mrs. Niemayer, who had recommended to Mr. Birch that he should buy the horse, later admitted that she had received a commission on the sale, although she refused to disclose how much she had been paid.
According to both counsel and solicitors, that would appear to prove that the vendor and his agent knew at the time of the sale that the horse was unsound and unsuitable for Mr. Birch's purposes. However, no mention was made of the conditions from which the horse was suffering. It should be made clear that the conditions do not necessarily give rise to continuous symptoms and that they are quite likely to escape detection during an inspection, especially if the horse has been doctored. There is evidence to show that Waltrap had been diagnosed and treated with a palliative drug of long-term effect while it was still in Mr. Samuel's ownership.
I know little about horses, but I am told that the degenerative joint diseases with which the horse had been diagnosed are progressive and incurable. The treatment that had been given to the horse did nothing and could do nothing to stop or slow down the progress of the disease. However, the drug that was administered made it difficult for even a qualified vet to diagnose the condition.
Following the discovery that Waltrap was unsuitable for the purpose for which he had been purchased, my constituent complained to the trading standards officers in Cambridge. They referred the complaint to Surrey trading standards officers, as that was where the Russian Horse Society was based.
Following a lengthy investigation, Surrey trading standards officers decided not to prosecute. The reasons for that were interesting in the circumstances. A letter from Mr. Ray Tapping, the legal manager of Surrey trading standards—I think that he still is—to Mr. Birch in June 1999 indicated that, in the absence of interviews with Mrs. Lansley and Mr. Meddes, and evidence from Mrs. Niemayer, there were too many questions and doubts.
Those potential witnesses had exercised their right to remain silent, so making it difficult for Surrey trading standards officers to investigate Mr. Birch's allegations properly. Mr. Birch is disappointed that the lengthy negotiations with Surrey trading standards officers led nowhere, and he is still keen that they should resume their investigations and commence proceedings under the Trade Descriptions Act 1968.
Mr. Tapping also advised that that best venue for deciding the matter was the civil courts, and indicated that he would be willing to release the evidence obtained by the Surrey trading standards investigating officer, subject to the necessary witness order by a court.
That is what happened, and after proceedings were issued, an attempt was made to dissolve the Russian Horse Society, which had transformed itself into Russian Horses Ltd. in August 1998. That was obviously done to escape the civil proceedings which Mr. Birch had commenced against it. However, he managed successfully to avert that

action by contacting Companies House. It is worth mentioning that the company is also known as Alex Crown Ltd., Eurovet Ltd., Anglo-Russian Export Ltd. and possibly other names as well. Mr. Birch's solicitors issued proceedings in September 1998 against three defendants—Duncan Samuel, the Russian Horse Society and Angela Niemayer Eastwood.
Judge Blomfield sat in judgment on the case. He said that he would like the action to be tried on its merits because it seemed clear that there were triable issues against Samuel, but he could not allow the case to be brought. There had been an election to pursue the second defendant. That choice was a bad one, as that defendant, the Russian Horse Society, had no assets as by that time they had been transferred to one of its sister companies, Eurovet Ltd. That defendant was therefore incapable of meeting a claim for compensation, however justified that would have turned out to be.
Under the provisions of the civil procedure rules, part 13.3(1)(b), the judge had the discretion to set aside the default judgment against the second defendant and had he done so, Mr. Birch's lawyers would then have been able to pursue the other defendants in the case. However, it was obviously a tactical error to choose the second defendant rather than the first. The judge said that the only reason for setting that default judgment aside was to enable the first defendant to be pursued. He said that he was persuaded that, if he did so, it would run counter to the underlying ethos of the Woolf reforms. It would also have the effect of prolonging litigation and adding uncertainty where Woolf seeks to provide a greater degree of certainty and clarity.
Unfortunately for my constituent, therefore, the judge had to strike out the case not only against the Russian Horse Society, but against the other defendants as well. Under part 13 of the new civil procedure rules, that also means that no other defendant could be tried. My constituent is therefore unable to seek redress for the expenses that he has incurred.
It is clear that my constituent has been badly advised by his solicitors in electing to pursue the Russian Horse Society. One course of action is open to him—to sue his solicitors for failing to check that the Russian Horse Society or Russian Horses Ltd., now Eurovet, was still a going concern, and for failing to warn him of the consequences of electing that defendant.
Mr. Birch finds it somewhat ironic that had he been a litigant in person, the court would have been duty bound to warn him of the consequences of the action that he pursued. Unfortunately, he now has no resources left to pursue his claim against his previous solicitors. He owes many thousands of pounds in court costs and is a long way from finding the justice that he deserves.
The purpose of this Adjournment debate is to ask my hon. Friend to look again at the procedure in default judgments in the light of this unfortunate case. Will he see whether the rules for discretion could be widened to allow a judge to set aside a default judgment when he feels that there is clearly an action that should be tried, as in this case?
I am well aware that if my hon. Friend can accede to this request, it will unfortunately not help Mr. Birch. However, there are several ways in which he could be helped. One would be for Surrey trading standards officers to re-open their investigation against the Russian


Horse Society and Duncan Samuel. I know that that is not likely at present, but if new evidence emerges, I hope that they will be encouraged to do so.
There have been allegations that witnesses have complained of threats and intimidation from Samuel. The Office for the Supervision of Solicitors has been asked to investigate, and Mr. Birch has submitted copies of letters from witnesses. However, the response has not been encouraging, and the OSS says that it will take some time to allocate a caseworker to the case. It is clear to me and to many other people that self-regulation of the legal profession is not working well at present, and that there needs to be another body to which people can complain.
I hope that my hon. Friend will be able to respond in a way that recognises the truly awful situation of my constituent, Derek Birch, and offers him some hope of a full investigation. I also ask my hon. Friend to consider whether there is a case for revising the guidelines concerning the new civil procedure rules in the light of this case.

The Parliamentary Secretary, Lord Chancellor's Department (Mr. David Lock): As my hon. Friend the Member for Cambridge (Mrs. Campbell) acknowledges, I must respond to the debate with some delicacy in the light of the particular case that is before the court. I cannot comment on the circumstances or intervene in an individual case, and it would not be right or proper for me to do so, particularly as that case may be the subject of appeal or enforcement proceedings hereafter. Nothing that I say should be taken to express any view on the facts of the case, which I get only from my hon. Friend's observations.
I have considerable sympathy for anyone who brings a case before the court and is unhappy with the result. The role of the courts, however, is to adjudicate cases on the evidence before them and on the course of action presented by those facts, not to advise claimants or suggest other avenues of action for them to explore. That would be incompatible with the principle of judicial independence and the duty of the judge to remain strictly impartial as between the parties before him.
Default judgments in the civil courts, which my hon. Friend mentioned, have been available for many years. They are an important feature of the civil justice system. They enable claimants to obtain a judgment for money due to them in a relatively simple and easy way, while providing important safeguards for defendants. In essence, the process seeks to balance the needs of the parties in a proportionate manner, while dealing with cases justly.
I have listened carefully to my hon. Friend, but must tell her that the Government have no plans to reform the law on default judgments, not least because Lord Woolf's substantial review of the civil justice system considered the issue only recently. For reasons I shall detail shortly, the issue that my hon. Friend is concerned with relates not so much to default judgments as to agency.
Prior to the review, default judgments were available in the High Court and the county court, although the procedures differed slightly. In the High Court, judgment was available for both default of acknowledgement of service and default of defence. In the county courts there was no acknowledgement of service, so there was scope for judgment only in default of defence.
Following the review, and as part of the civil justice reforms brought into effect in April 1999, unified civil procedure rules were introduced for the High Court and the county courts, including those covering default judgments. It might be helpful if I explain the default judgment procedure.
An admission, an acknowledgement of service or a defence must be filed by a defendant within 14 days of the service of the particulars of claim. Where an acknowledgement of service is filed, defendants have 28 days to file a defence. If a defendant fails to comply with those requirements, the claimant can, in the majority of cases, request or apply for a default judgment for a specific sum.
A default judgment is a devolved administrative act that requires no judicial input. It requires staff to check that there has been no reply as indicated in the claimant's request, and that the time for doing so, calculated from the date of service, has expired. Nor is there any issue about costs for judicial decision, as costs are fixed by rule according to the amount claimed. The claimant is required to tell the court of any payment that would reduce the amount claimed so that the defendant is not disadvantaged where a payment may cross in the post with the service of the claim form.
In cases where the claim is unspecified there is a clear need for judicial intervention, and the rules provide for that. That is the important distinction between claims for specified and unspecified amounts. On receipt of the request for application and providing the relevant conditions have been satisfied, judgment may be entered in default. A judgment may be for the full amount, for an amount to be decided by the court, for costs only or for specified amounts at specified periods. An interest claim from the date of the judgment may be included in certain circumstances.
Certain safeguards for defendants are built into the system. Defendants who feel they need more time to prepare their defence may be able to agree that with the claimant or may ask the court for an extension. Defendants who fail to acknowledge service or provide a defence will be aware of the implications. Notes for defendants that accompany the claim make it clear that failure to reply may result in a judgment being entered against the defendant.
If claimants subsequently become aware that a defendant had not received the particulars of claim when judgment was entered, they must ask the court to set aside the judgment or ask the court for directions. The claimant cannot seek to enforce a judgment until either the application to set aside or the application for directions has been disposed of.
That summarises the current law concerning default judgments. As I have said, I am not able to comment on the case referred to by my hon. Friend, but cases of this type can sometimes turn on the question whether an agent is sued rather than the real owner of goods—in law referred to as the principal. The law on agency in this context is not straightforward or always clear, but put broadly—I risk the danger of oversimplification; this may not be appropriate to the case of my hon. Friend's constituent—where a person has entered into a contract through an agent, whether he knew of the existence of the


principal or otherwise, and where he obtains a judgment against that agent, he may not later sue the principal in relation to the same matter.
In addition, where a person elects to sue an agent and not a principal, although he knew at the time when the contract was made who the real principal was, or discovered it later, he again may not sue the principal in relation to the same matter. The question whether such an election has taken place is one of fact and depends on the circumstances of the particular case.
The fact that a judgment has been made against a company with no apparent assets does not mean that it is without effect. The company may well have assets in the form of claims against directors or other persons associated with it, or against linked companies if, for example, the directors have acted in breach of their fiduciary duty to the company at or about the time when assets are moved in relation to transactions involving the company or in any other related way. Therefore, a company that, on the face of it, has no assets, may none the less be a valuable entity that, through one mechanism or another, may provide a vehicle for enforcing a judgment, including any judgment for costs obtained in an action. That is obviously a matter on which my hon. Friend's constituent would have to seek advice, and I offer those remarks merely by way of guidance.
My hon. Friend referred to the conduct of solicitors. As she accepted, that is a matter for their professional body, the Law Society. Solicitors are members of an independent and self-regulating profession, and the Lord Chancellor, his Ministers and officials cannot intervene in specific cases or comment on complaints about members of the legal profession. The Law Society has the responsibility in the first instance to ensure that solicitors observe proper standards of behaviour when dealing with their clients, other solicitors and the courts.
The Office for the Supervision of Solicitors is a separate organisation set up by the Law Society to handle complaints against its members. The Law Society, through the office, investigates complaints of inadequate professional service and professional misconduct. Allegations of negligence will be reviewed by the office, which, as it cannot give legal advice, has set up a panel of independent solicitors to which such allegations may be referred. The panel solicitors will advise the complainant on whether a solicitor has been negligent

and, if so, what action can be pursued. It is thereafter a decision for the complainant as to how to pursue the matter.
As my hon. Friend said, there are certain problems with the operation of the Office for the Supervision of Solicitors, but there is some indication of a commitment by the Law Society to solve them. I was heartened by the approach taken by the newly elected president of the Law Society, Mr. Michael Napier, immediately on his election. He stressed that sorting out the complaints system and improving the quality of client care are high priorities for his presidential year. I am sure that my hon. Friend will join me in welcoming that important statement. There must be a step change in the standard of client care by solicitors.
There is also a backlog and problems with quality at the Office for the Supervision of Solicitors. Both are being tackled, but, as I am afraid the report from the legal services ombudsman released earlier this week shows, there is still a very long way to go before we can be confident that the Law Society, through the office, has a properly functioning complaints procedure. However, in cases where it has established that a client has received inadequate professional service, the office can award compensation of up to £5,000. That issue was raised by my noble Friend the Lord Chancellor earlier this year.
I have considerable sympathy for Mr. Birch and his predicament, and appreciate that he will have to seek further legal advice if he wishes to pursue the matter. However, I can tell my hon. Friend only that, since May, all actions, with the exception of family cases, can be pursued by solicitors on a no win, no fee basis on what is called a conditional fee arrangement. If her constituent has a good case to pursue against the people who left him in this unfortunate situation, I am confident that he will be able to find a solicitor who will back his or her judgment, enter into a no win, no fee agreement and therefore perhaps provide him with an avenue for justice. However, he must pursue that matter and find his own lawyer, who will act wholly independently of the Government, as is right.
Default judgments are not the core of the problem that my hon. Friend has raised, though I hope that some of my observations may assist in describing one or two avenues that her constituent might wish to pursue.

Question put and agreed to.

Adjourned accordingly at four minutes past Three o'clock.